The document summarizes a review of evidence on whether computerized provider order entry (CPOE) systems are effective in reducing prescribing errors. The review found the quality of evidence was moderate to poor, with high variability making it difficult to draw conclusions. Most studies found CPOE reduced prescribing error rates, but it remains unclear which specific errors were reduced and how much potential patient harm was decreased. More research is needed to determine CPOE's efficacy in reducing prescribing errors.
Background: The Food and Drug Administration relies on adverse event reports linked with health risks to remove potentially harmful dietary supplements from the market. Many emergency medicine physicians encounter suspected adverse events related to
dietary supplement use but we do not know what proportion of those adverse events are reported to the Food and Drug Administration. The objective of the study was to determine emergency medicine physicians’ practices regarding adverse event reporting and knowledge of dietary supplements.
Methods: A prospective, cross-sectional study was conducted across five medical centers around the U.S: three military and two civilian. A web-based survey was distributed to emergency medicine attending physicians and emergency medicine residents. The questionnaire was created and administered using Lime Survey software. An administrator at each site communicated study details to emergency medicine physicians and residents via email. The survey was kept open for fi ve months. To preserve participant anonymity,
neither email domains, email addresses, Internet Protocol addresses, nor any other personally identifi able or demographic information were collected.
Classifying Readmissions of Diabetic Patient EncountersMayur Srinivasan
Readmission rates in hospitals are a key indicator on quality of patient care and a clear indication of total cost or inconvenience related to the treatment. Patients with serious medical
conditions such as diabetes mellitus are key drivers of readmission rates owing to the complexity of their illness. Therefore, being able to predict based on certain features whether or not a patient
will need readmission can help doctors and hospitals provide better care initially and not get financially penalized under Obamacare’s readmission policy
Innovations conference 2014 erica wales does an online anti-cancer medicati...Cancer Institute NSW
Erica Wales - Does an Online Oral Anti-cancer Medication Education Program Targeted at Community Pharmacists Improve their Knowledge and Confidence in Dispensing Oral Anti-cancer Medication
Measuring to Improve Medication Reconciliationin a Large Sub.docxalfredacavx97
Measuring to Improve Medication Reconciliation
in a Large Subspecialty Outpatient Practice
Elizabeth Kern, MD, MS; Meg B. Dingae, MHSA; Esther L. Langmack, MD; Candace Juarez, MT; Gary Cott, MD;
Sarah K. Meadows, MS
Background: To assess performance in medication reconciliation (med rec)—the process of comparing and reconciling
patients’ medication lists at clinical transition points—and demonstrate improvement in an outpatient setting, sustainable
and valid measures are needed.
Methods: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory
practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs),
and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR).
New measures designed to assess med rec performance, and to validate the measures, were derived from EHR data.
Results: Across 18 months, electronic attestation that med rec was completed at clinic visits increased from 9.8% to 91.3%
(p < 0.0001). Consistent with this improvement, patients with medication lists missing dose/frequency for at least one prescription-
type medication decreased from 18.1% to 15.8% (p < 0.0001). Patients with duplicate albuterol inhalers on their list decreased
from 4.0% to 2.6% (p < 0.0001). Percentages of patients increased for printing of the medication list at the visit (18.7% to
94.0%; p < 0.0001) and receipt of the printed medication list at the visit (52.3% to 67.0%; p = 0.0074). Documentation
that patient education handouts were offered increased initially then declined to an overall poor performance of 32.4% of
clinic visits. Investigation of this result revealed poor buy-in and a highly redundant process.
Conclusion: Deriving measures reflecting performance and quality of med rec from EHR data is feasible and sustainable
over the time periods necessary to demonstrate change. Concurrent, complementary measures may be used to support the
validity of summary measures.
Medication reconciliation (med rec) is the process of sys-tematically and comprehensively reviewing the
medications a patient is taking, to ensure that medications
added, changed, or discontinued are evaluated for poten-
tial safety concerns. One of the three current Joint
Commission National Patient Safety Goals (NPSGs) on med-
ication safety (Goal 3), concerns medication reconciliation,
which ambulatory care organizations have been expected to
perform since 2005. The current version of the goal
(NPSG.03.06.01), effective July 1, 2011, stipulates that am-
bulatory care organizations maintain and communicate
accurate patient medication information.1 One require-
ment is that the organization obtain the patient’s medication
information at the beginning of an episode of care, with the
information to be updated when the patient’s medications
change. Ideally, med rec should occur at each transition of
care or han.
Background: The Food and Drug Administration relies on adverse event reports linked with health risks to remove potentially harmful dietary supplements from the market. Many emergency medicine physicians encounter suspected adverse events related to
dietary supplement use but we do not know what proportion of those adverse events are reported to the Food and Drug Administration. The objective of the study was to determine emergency medicine physicians’ practices regarding adverse event reporting and knowledge of dietary supplements.
Methods: A prospective, cross-sectional study was conducted across five medical centers around the U.S: three military and two civilian. A web-based survey was distributed to emergency medicine attending physicians and emergency medicine residents. The questionnaire was created and administered using Lime Survey software. An administrator at each site communicated study details to emergency medicine physicians and residents via email. The survey was kept open for fi ve months. To preserve participant anonymity,
neither email domains, email addresses, Internet Protocol addresses, nor any other personally identifi able or demographic information were collected.
Classifying Readmissions of Diabetic Patient EncountersMayur Srinivasan
Readmission rates in hospitals are a key indicator on quality of patient care and a clear indication of total cost or inconvenience related to the treatment. Patients with serious medical
conditions such as diabetes mellitus are key drivers of readmission rates owing to the complexity of their illness. Therefore, being able to predict based on certain features whether or not a patient
will need readmission can help doctors and hospitals provide better care initially and not get financially penalized under Obamacare’s readmission policy
Innovations conference 2014 erica wales does an online anti-cancer medicati...Cancer Institute NSW
Erica Wales - Does an Online Oral Anti-cancer Medication Education Program Targeted at Community Pharmacists Improve their Knowledge and Confidence in Dispensing Oral Anti-cancer Medication
Measuring to Improve Medication Reconciliationin a Large Sub.docxalfredacavx97
Measuring to Improve Medication Reconciliation
in a Large Subspecialty Outpatient Practice
Elizabeth Kern, MD, MS; Meg B. Dingae, MHSA; Esther L. Langmack, MD; Candace Juarez, MT; Gary Cott, MD;
Sarah K. Meadows, MS
Background: To assess performance in medication reconciliation (med rec)—the process of comparing and reconciling
patients’ medication lists at clinical transition points—and demonstrate improvement in an outpatient setting, sustainable
and valid measures are needed.
Methods: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory
practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs),
and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR).
New measures designed to assess med rec performance, and to validate the measures, were derived from EHR data.
Results: Across 18 months, electronic attestation that med rec was completed at clinic visits increased from 9.8% to 91.3%
(p < 0.0001). Consistent with this improvement, patients with medication lists missing dose/frequency for at least one prescription-
type medication decreased from 18.1% to 15.8% (p < 0.0001). Patients with duplicate albuterol inhalers on their list decreased
from 4.0% to 2.6% (p < 0.0001). Percentages of patients increased for printing of the medication list at the visit (18.7% to
94.0%; p < 0.0001) and receipt of the printed medication list at the visit (52.3% to 67.0%; p = 0.0074). Documentation
that patient education handouts were offered increased initially then declined to an overall poor performance of 32.4% of
clinic visits. Investigation of this result revealed poor buy-in and a highly redundant process.
Conclusion: Deriving measures reflecting performance and quality of med rec from EHR data is feasible and sustainable
over the time periods necessary to demonstrate change. Concurrent, complementary measures may be used to support the
validity of summary measures.
Medication reconciliation (med rec) is the process of sys-tematically and comprehensively reviewing the
medications a patient is taking, to ensure that medications
added, changed, or discontinued are evaluated for poten-
tial safety concerns. One of the three current Joint
Commission National Patient Safety Goals (NPSGs) on med-
ication safety (Goal 3), concerns medication reconciliation,
which ambulatory care organizations have been expected to
perform since 2005. The current version of the goal
(NPSG.03.06.01), effective July 1, 2011, stipulates that am-
bulatory care organizations maintain and communicate
accurate patient medication information.1 One require-
ment is that the organization obtain the patient’s medication
information at the beginning of an episode of care, with the
information to be updated when the patient’s medications
change. Ideally, med rec should occur at each transition of
care or han.
An Internet questionnaire to identify Drug seeking behavior in a patient in t...Nelson Hendler
Drug seeking behavior in patients with little or no real pain, has led to the opioid crisis. Until now, there was no reliable method for detecting drug seeking behavior. The Pain Validity Test from www.MarylandClinicalDiagnostics.com can predict with 95% accuracy who will have medical test abnormalities, i.e. who has a valid complaint of pain, and predicts with 85%-100% accuracy who will not have any medical test abnormalities, i.e. who is faking and drug seeking. The Pain Validity Test has been admitted as evidence in over 30 legal cases in 8 states.
Pain Validity Test to detect drug seeking behaviorNelson Hendler
The Pain Validity Test predicts which patient will have medical test abnormalities with 95% accuracy, thereby validating their complaint of pain. The Pain Validity Test also predicts with 85%-100% accuracy who will not have medical test abnormalities, thereby detecting drug seeking behavior, faking and malingering.
Pain Validity Test identifies drug seeking behavior. Stop opioid abuse. Prote...Nelson Hendler
Physician prescribing practices are under constant scrutiny. An Internet questionnaire will predict if a patient will have a medical test abnormality with 95% accuracy, and 100% if the patient will not. This Pain Validity Test can be used to detect drug seeking behavior in patients, at a far high level of accuracy than tests currently in use (34.4%-48.2% accuracy).. The Pain Validity test has been admitted as evidence in 30 cases in 9 states.
Addressing pediatric medication errors in ED setting utilizing Computerized P...Arete-Zoe, LLC
Pediatric patients who are treated in general acute care hospitals are at increased risk of medication errors. The main reasons are the lack of experience with the special needs of pediatric patients, their lower ability to tolerate medication errors, medication-related problems such as forms and packaging designed primarily for adults and labeling with insufficient information on the dosing of pediatric patients. Medication errors can be reduced significantly by appropriate medication management systems. Computerized Provider Order Entry (CPOE) systems reduce the frequency of medication errors in all stages of the process. IT technology introduces an additional vulnerability in the form of IT-related medication errors. Nurses are the last individuals in the medication management process who can detect and intercept a medication error and prevent incorrect medication orders from reaching and harming their patients. To be able to do so, nurses have to be familiar with the medication management system in their hospital and escalate incorrect orders as appropriate and relevant.
Running Head: STATISTICS 1
STATISTICS 2
The article seeks to show a clear understanding on how one can analyse a given set of data using inferential statistics. The article used, in this case, involved a research study on "Influence's that hospitalization has on prescribing safety across the continuum of care". The main aim of the study was exploring the role played by hospitalization towards exposure to prescription error and medication-related communication. The scope of study involved an only patient who is normally transferred from and back of the ambulatory care. The research hypothesis clearly addresses the problem by providing a vivid description on how different levels of transitions pose a potential threat to continuity and quality of drug therapy.
The purpose of the study section emphasizes on how the research will be much involved in identifying and showing how the various factors which predispose individuals into prescription errors resulting from hospitalization. The aspect of showing is clear indication that correlation and regression methodologies were used to analyse the collected data.
The main method used to collect data for the study was interviewing. The sampling method was also used to collect data from the various health records such as referral letters and doctors recommendations. The collected data was analysed using various tests. First 95 % confidence was calculated using Clopper-Pearson binomial distributions assumptions. Binary logistic regression with the help of stepwise approach was used to identify the risk factors that lead to inappropriate prescribing as a result of hospitalization.
The benefits associated with correlation and regression analysis is the fact that it is easy to work out and interpret (Kam and Franzese, 2007). The finding of the research established that only 1 out of 19 patients can receive the same standard of medication as they enter the hospitals as well as the time of leaving. The rest of the patients are normally exposed to variations experienced between the admission and discharge prescriptions. In general, almost 9 out of 10 of all the affected patients experiences medication changes.
References
Asadoorian, M. O., & Kantarelis, D. (2005). Essentials of inferential statistics. Lanham: University Press of America.
Kam, C. D., & Franzese, R. J. (2007). Modeling and interpreting interactive hypotheses in regression analysis. Ann Arbor: University of Michigan Press.
References
Asadoorian, M. O., & Kantarelis, D. (2005). Essentials of inferential statistics. Lanham: University Press of America.
Kam, C. D., & Franzese, R. J. (2007). Modeling and interpreting interactive hypothese.
Traditionally, physicians recruited clinical trial subjects, but pharmaceutical companies have become ever more involved through centralized campaigns. Physicians are vital to a trial and the pharmaceutical effort helps shift some of the recruitment demands away from the site to allow them to focus on the subjects. Thus, it is practical to understand if different recruitment methods could change or skew the study population. This study determines if differences or similarities occurred between subjects recruited by physicians and pharmaceutical companies. It discovered that some of both occurred. The pharmaceutical company efforts helped recruit potential subjects from the general population that were similar to subjects recruited by the physicians, but this particular campaign was limited by language which affected recruitment of Hispanic subjects. The social impact of this study provides insight about pharmaceutical company recruitment. Since the National Library of Medicine has indicated that clinical trials should reflect the broader diseased population, the efforts of the pharmaceutical company can help support the physicians’ efforts by recruiting from the broader population. Together, both efforts can create a global good by allowing the trial to reflect the population of post-approval use. These findings still raise a question about the proper balance between the two recruitment groups so that the intended characteristics of the diseased population are maintained. Because differences between physician and pharmaceutical recruited subjects can exist, the potential of one group to bias the trial results exist. As such, some analysis by recruitment method can help ensure that variations in the study population are minimal without skewing the data to create positive study results.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
![CPOE and Prescribing Errors Daniel Ceppos University of Maryland School of Nursing Purpose The purpose of this review is to evaluate the evidence for effectiveness of CPOE systems in reducing prescribing errors in both inpatient and outpatient settings. ,[object Object],[object Object],[object Object],[object Object],[object Object],Background CPOE systems allow electronic order entry for medications, labs, imaging, referrals, and procedures (Devine et al., 2010). CDS systems are sometimes used with CPOE to check medication orders for errors (Kadmon et al., 2009). While several healthcare associations have endorsed CPOE, the role of CPOE in reducing prescribing orders remains unclear (Kadmon et al., 2009). Methods Databases searched : Ovid Medline and CINAHL Key words : “CPOE,” “medication” and “error” Inclusion criteria : Peer-reviewed articles, English language, published 2001–2011. Exclusion criteria : Systematic reviews, integrated reviews, meta-analyses, studies on transcription errors or prescribing error epidemiology, and laboratory and simulation studies. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Key Terms CDS : clinical decision support CPOE : computerized provider order entry Medication error : an error at any step in the medication process (Krahenbuhl-Melcher et al., 2007). Prescribing error : an error in prescribing decision or prescription writing (Dean et al., 2000). Transcription error : An error in prescription transcription or misinterpretation of prescriptions (Krahenbuhl-Melcher et al., 2007). Literature Profile The author reviewed the abstracts of all 71 hits. Nine studies ultimately met inclusion criteria. Seven of these were available and were reviewed. Of these seven, three were evidence level IIB, one was IIC, two were IIIB, and onc was IIIC. References Dean, B., Barber, N., & Schachter, M. (2000). What is a prescribing error? Quality in Health Care, 9 (4), 232-237. Devine, E. B., Hansen, R. N., Wilson-Norton, J. L., Lawless, N., Fisk, A. W., Blough, D. K.,... Sullivan, S. D. (2010). The impact of computerized provider order entry on medication errors in a multispecialty group practice. Journal of the American Medical Informatics Association, 17 (1), 78-84. Kadmon, G., Bron-Harlev, E., Nahum, E., Schiller, O., Haski, G., & Shonfeld, T. (2009). Computerized order entry with limited decision support to prevent prescription errors in a PICU. Pediatrics, 124 (3), 935-940. Krahenbuhl-Melcher, A., Schlienger, R., Lampert, M., Haschke, M., Drewe, J., & Krahenbuhl, S. (2007). Drug-related problems in hospitals: A review of the recent literature. Drug Safety, 30 (5), 379-407. Abstract While several health-care associations have endorsed computerized provider order entry (CPOE) as a tool in reducing medication errors, the role of CPOE in reducing prescribing orders remains unclear. The purpose of this review is to evaluate the evidence for CPOE's role in reducing prescribing errors in inpatient and outpatient settings. The author conducted a search of Ovid Medline and CINAHL databases and ultimately reviewed seven articles that met inclusion criteria. Given the current evidence, it is unclear how much CPOE reduce potential patient harm. Further research is needed to determine the efficacy of CPOE in reducing prescribing errors.](https://image.slidesharecdn.com/virtualposter-111128103620-phpapp01/85/Virtual-Poster-1-320.jpg)
