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The #COVID19 Government Measures Dataset puts together all the measures implemented by governments worldwide in response to the Coronavirus pandemic. trol of the disease in many countries, including Italy and. Portugal,11 In a recent large survey including almost patients with COPD selected by the. A radiological image analysis framework for early screening of the COVID infection: A computer vision-based approach. A study conducted on 80 school buildings (characterized by different features and construction technologies) located in central Italy (the Lazio region). Commons Attribution (CC BY) license, which allows users to download, copy and build Figure 2 also shows, for small window sizes ranging from 10 to ❿
 
 

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Windows 10 1703 download iso italy covid vaccine/scheduling
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Still, any other languages or platforms can be used to implement the same. It is assumed that there are no manual annotations available and the proposed approach is capable to process the images without having any prior knowledge. The final segmented images are constructed by assigning the superpixel to their corresponding cluster centers.
These segmented images are helpful to interpret different features from these radiological images. Appl Soft Comput. Published online Feb 3. Author information Article notes Copyright and License information Disclaimer. All rights reserved. Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre – including this research content – immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source.
Abstract Due to the absence of any specialized drugs, the novel coronavirus disease or COVID is one of the biggest threats to mankind Although the RT-PCR test is the gold standard to confirm the presence of this virus, some radiological investigations find some important features from the CT scans of the chest region, which are helpful to identify the suspected COVID patients.
Introduction Automated computer-aided systems prove their effectiveness and real-life applicability in various scenarios. Table 1 Some of the related literatures and their brief overview. The calibrated source-to-background curves are used to determine the volume using the iterative thresholding procedure. One major drawback of the system is that it cannot effectively measure small volumes.
Wiemker et. This work proposes a divergence theorem and histogram-based Ct image segmentation approach. This approach is can effectively and optimally isolate the lung nodules from the CT scan images. In this context, the optimality is defined in terms of the mean gradient of the iso-surface and the sphericity.
Asari et. This algorithm is consisting of two stages where the first stage employs a global thresholding approach and in the second phase, the differential region growing is used to extract the gastrointestinal lumen from the endoscopic images.
The dynamic hill-clustering approach is used to ascertain the effectiveness of the termination criteria and to look after the growth process. Yu-qian et. Traditional gradient-based edge detection approaches are susceptible to noise and therefore, this approach proposes a novel approach to detect edges of the lung CT scan images using mathematical morphology.
This approach is tested on the CT images which are corrupted with the salt-and-pepper noise and its efficiency is proved by comparing this approach with some of the other standard approaches. It is observed that this approach can efficiently reduce the effect of noise and also can generate precise edges. Falcao et. This approach is highly dependent on the user intervention to efficiently determine the segmented regions and to define the objects.
This approach is found to be 3 to 15 times faster compared to manual tracing. This approach can be applied almost independently to the applications.
One main problem associated with this method is the difficulties associated with the choice of slabs and orthogonal slices which has a serious impact on the efficiency of this approach.
Pan et. The proposed approach addresses the problem of discontinuous edges and dependency on the initialization which are associated with the traditional edge detection approaches. In this work, the intensity of the gradient images is modeled as the concentration of the nutrients and the property of the bacteria Escherichia coli. The edges are highlighted as the paths of the bacteria. Although this approach performs well and comparative study shows the effectiveness of the proposed approach still, one problem of this approach is not very robust to noise.
Noise can lead to crumpled edges. This approach is not also suitable to handle overlapped cells. Ji et. Traditional fuzzy C-means clustering approach does not consider the spatial information and less robust to noise. This work proposes a modification which is known as the weighted image patch-based FCM. In this work, pixels are replaced with the weighted patches which is helpful to incorporate spatial information in the segmentation process.
It is helpful to increase the reliability of the overall segmentation process but it also increases the computational overhead drastically. Agrawal et. This work proposes a novel hybrid approach which is based on the genetic algorithm and the bacterial foraging algorithm. The combination of these two approaches is used to optimize the objective function of the fuzzy c-means clustering. The final cluster centers are obtained using a method called optimum boundary point detection. This approach cannot determine the optimal number of clusters automatically and produces inaccurate results if the predefined clusters and the actual number of clusters differ.
This approach is based on intuitionistic fuzzy set theory and it is known as the intuitionistic fuzzy C means clustering. In this work, a novel objective function which is known as intuitionistic fuzzy entropy is incorporated with the traditional fuzzy C-means clustering. This approach is applied to different CT scan images to prove its efficiency. Miao et. This approach can be divided into two phases where the first phase incorporates a dictionary learning method to handle the noise.
In the second phase, this dictionary learning approach is hybridized with the Improved fuzzy c-means clustering approach. The proposed approach is not efficient for medical images with inhomogeneous intensity distribution. Open in a separate window. A brief overview of the artificial cell swarm optimization procedure This is a recently developed metaheuristic procedure that is inspired by the artificial cell division procedure.
The incorporated modifications are listed below [47] : i. The artificial cells are not depending on the current state to participate in the cell division process. Fuzzy C-means clustering based on type 2 fuzzy system The proposed approach adopts the type 2 fuzzy logic-based clustering approach to effectively model and handle the random uncertainties.
A point with higher uncertainty has a lesser impact on the overall clustering process and vice-versa. It helps to achieve more realistic results. Proposed method of superpixel computation The ever-growing technology allows us to increase the quality of the image acquisition hardware.
Table 3 Details of the CT scan images under test. Proposed superpixel coupled fuzzy ACSO approach-based segmentation The conventional fuzzy C-means clustering approach often overlooks some important spatial information that can be costly in terms of the segmentation performance. Dataset description CT scan images of the chest region are collected from the COVID positive patients from different geographic regions.
Experimental results The experiments are performed in the MatLab Ra on a computer that is equipped with an Intel i3 processor and 4 GB main memory. Table 4 Performance evaluation of different approaches using Davies—Bouldin index The highlighted values indicates acceptable values.
Image Id Algorithm No. Table 5 Performance evaluation of different approaches using Xie—Beni index The highlighted values indicates acceptable values. Table 6 Performance evaluation of different approaches using Dunn index The highlighted values indicates acceptable values.
Table 8 Comparison of the proposed approach with the active contour method. Study of the convergence rate The rate of convergence is an important parameter to be studied.
Analysis of the complexity The time complexity is an important aspect that is to be analyzed. Discussion 6. Threats to validity The obtained results indicate that the proposed approach is suitable for real-life scenarios and also performs efficiently. Limitations Although the proposed approach is efficient enough to segment the CT scan images automatically and produces realistic segmented outcomes still, some important drawbacks can be observed in this proposed approach that can be addressed in the subsequent works.
Conclusion This article proposes a novel, simple and elegant solution that uses some of the important features of the chest CT scan images to screen the COVID suspected patients easily and at an early phase which can be considered as an effective tool to reduce the drastic spread of this virus. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgments The authors would like to express their gratitude and thank the editors, anonymous reviewers, and referees for their valuable comments and suggestions which are helpful in further improvement of this research work.
Software setup The system in which the experiments are carried out is equipped with the Microsoft Windows 7 64 bit operating system. References 1. Kim T. Learning full pairwise affinities for spectral segmentation. IEEE Trans. Pattern Anal. Chakraborty S. In: Chakraborty S. IGI Global; An overview of biomedical image analysis from the deep learning perspective. Object Recognit. Motion Detect. Video Process. A study on different edge detection techniques in digital image processing; pp.
Libbrecht M. Machine learning applications in genetics and genomics. Tang C. IEEE Int. BIBE Interrelated two-way clustering: An unsupervised approach for gene expression data analysis; pp.
In: Appl. IGI GLobal; An advanced approach to detect edges of digital images for image segmentation. Expert Syst. Multi-Objective Optim. Springer Singapore; Singapore: Application of multiobjective optimization techniques in biomedical image segmentation—A study; pp. Springer; An optimized intelligent dermatologic disease classification framework based on IoT; pp. Hore S. An integrated interactive technique for image segmentation using stack based seeded region growing and thresholding.
IEEE; Contrast optimization using elitist metaheuristic optimization and gradient approximation for biomedical image enhancement; pp. Opto-Electronics Appl. Optronix An integrated method for automated biomedical image segmentation. Mesejo P. A survey on image segmentation using metaheuristic-based deformable models: State of the art and critical analysis. Soft Comput. Chen X. IEEE Rev. In: Adv. Metaheuristic Comput. Dey N. Intelligent computing in medical imaging: A study; pp.
Campadelli P. Notes Comput. Including Subser. Notes Artif. Notes Bioinformatics Springer Verlag; Liver segmentation from CT scans: A survey; pp. Litjens G. A survey on deep learning in medical image analysis. Image Anal. Jentzen W. Segmentation of PET volumes by iterative image thresholding.
Wiemker R. Optimal thresholding for 3D segmentation of pulmonary nodules in high resolution CT. Asari K. A fast and accurate segmentation technique for the extraction of gastrointestinal lumen from endoscopic images.
Zhao Y. IEEE Eng. Medical images edge detection based on mathematical morphology; pp. A 3D generalization of user-steered live-wire segmentation. Pan Y. Cell image segmentation using bacterial foraging optimization. Fuzzy c-means clustering with weighted image patch for image segmentation. Agrawal S. A study on fuzzy clustering for magnetic resonance brain image segmentation using soft computing approaches.
Chaira T. A novel intuitionistic fuzzy C means clustering algorithm and its application to medical images. Miao J. Local segmentation of images using an improved fuzzy C-means clustering algorithm based on self-adaptive dictionary learning. Signal Process. Ding W. Fuzzy Syst. Chen H. Results from central laboratory are generally considered valid a priori.
In the POCT setting, validation is responsibility of personnel performing the test, usually “non-laboratory” people who do not have the training that laboratory professionals do. Validation of a result must also take into account at least the correctness of the pre-analytical and analytical phases, the devices functionality, as well as the verification of quality through the control systems.
Controlling panic and delta check ranges adds further complexity. We can combat these risks of error with continuous training, such as in the pre-analytical and analytical phases; using updated technologies, which allow self-checks, warning systems, blocking of results in case of non-compliance with quality specifications, etc.
We are near the start of Artificial Intelligence and utilizing big data to prove competency of operators, to prove that meters were giving reliable results, close to the other meters in the hospital and to maintain quality control in devices used outside of the hospital and operated by nurses, emergency medical technicians, and others not laboratorians [1].
Numerous studies have shown that reporting can be a critical element, when the execution of the tests is very far from the control of the central laboratory. The incorrect laboratory report is the most relevant issue for the post-analytical POCT phase, and specific quality indicators specific quality indicators could be very useful or even mandatory soon [3].
Specific competence counts in the interpretation of the results. For some tests, such as blood gas tests or thromboelastometry, the skills of specialists who have POCT systems at their points of care are likely to be high, often the highest in the health care system. However, there is evidence for others tests and other clinical contexts monitoring tests [4] or management of critical results [5] the situation is very variable and sometimes worrying.
The training of operators and the assessment of skills must therefore also concern, and with particular attention, the clinical significance of the results and the actions to be taken in the event of critical or unusual results. Miller JA. Quality performance of laboratory testing in pharmacies: a collaborative evaluation. Clin Chem Lab Med ; Pract Lab Med ;e Medicina Kaunas.
J Appl Lab Med 1; ISO and ISO enforce the implementation of dashboards, indicators, and patient risk management to continuously improve diagnostic outcome quality and TAT reduction. Our laboratory studied a year-old patients who underwent synthetic treatment or prosthetic surgery for femoral fractures within 48 h of admission and had symptoms attributable to ischemic heart disease dyspnea, chest pain, arrhythmia, and hypotension.
Troponin dosage was measured in all these patients with third-party POCT quality controls; these controls were validated by dedicated software to reduce analytical variability and allow monitoring of high-risk patients directly in TIPO by cardiologists with protocol 0—1 h; this also allowed the laboratory to measure, assess and reduce the risk of harm to the patient by IQCP system Individualized Quality Control Plan and monitoring integrated software as guidelines means to guarantee and protect above all the physician and the patient.
Healthcare is the one of the largest success stories of our times. Technology is another of the largest success stories of our times.
We are in the middle of a health-tech secular change. This is for good. This is unstoppable. This is the best part of the story. Yet, healthcare spending is unsustainable in an aging world.
Technology, as every tool, brings its risks. Global levels of assistance are outrageously unequal. Mental disorders are exponentially growing. How will the lab of the future adapt to the entire story? Internet of Things will be the main key to acquire all the right data.
Artificial Intelligence will be non-optional. With health-related knowledge doubling in months, AI will become a mandatory survival kit. Yet, it still will see things that human eye might miss. Or making correlations that are simply too difficult anyway else.
Yes, it will be both defensive for professionals and offensive to diseases, if used in the right way, as every tool. Digital will influence behaviors, create communities, and redefine the patient-professional interaction. Patients are individuals, parents, children, workers, citizens, consumers, with ever-growing expectations on what and how can be done through a smartphone.
Space and satellite technology will provide the communication background for all above, from remote surgery to distributed expert network, etc. But Space will also bring additional data coming from macroscopic data gathering, earth observation, context-related data and gravity-less phenomenon analysis. Can the lab of the future stay immune from all above? Hard to believe. While exact predictions are useless, some trends are clearly visible and point to the raise of a next-generation ubiquitous lab.
The complete blood count CBC is one of the most requested tests, routinely performed in the central laboratory LAB by large haematological analysers, useful to diagnose many diseases and manage urgent clinical decisions such as transfusion or administration of chemotherapy and antibiotics. Hb remains the most common POCT in haematology, essential to exclude anaemia. There are two types of technology: small benchtop analysers and portable devices.
The latter, some of which use disposable cartridges, do not require start-up procedures, maintenance and calibrations. The latest generation of portable devices combines advanced digital technology with innovative technologies of viscoelastic focusing and microfluidics and techniques, such as digital microscopy and computer vision, using near infrared spectroscopy and the absorption of light at multiple wavelengths, obtaining CBC results unthinkable until a few years ago.
Poor finger prick technique can provide misleading results, it was proved that capillary samples significantly underestimate PLTs overestimating Hb and WBCs, but differences have not clinical relevance when the samples are collected according to standardized procedures. POCT devices can not differentiate normal cells from pathological ones e.
As recommended by the guidelines, due to the inherent risk of preanalytical errors and the standard risk of error during analytical and postanalytical phases, threshold values must be established to repeat CBC in a LAB. Literature suggests that POCTs are not yet the ideal tools to perform CBC for diagnostic purposes, but they are useful in urgent situations such as rapid monitoring of some parameters e.
Further studies are needed to confirm the promising results of POCTs and evaluate their performance even at low ranges and in pathological conditions. Rampoldi E. Carraro P. Biochim Clin ; Briggs C.
Where are we at with point-of-care testing in haematology?. BJH ; — Mooney C. Point of care testing in general haematology. Machine learning algorithms have proven to be very effective in predicting the behavior of phenomena represented in biomedical data. The most commonly used machine learning algorithms, such as artificial neural networks, produce so-called “black box” results, namely: a complex set of mathematical equations that cannot be interpreted by people who do not have in-depth mathematical skills;.
When applying machine learning to data such as images, black box algorithms are not a problem, since the value of the model lies in its accuracy in detecting the presence of certain patterns, attributable, for example, to the presence of a tumor.
A specific ML technique, the Rulex “rule generation method”, builds models described by a set of intelligible rules, thus allowing the extraction of important knowledge regarding the variables included in the analysis and their relationships with the outcomes of the phenomenon analyzed. Introduction: Point-of-care testing POCT is laboratory testing conducted close to the site of patient care.
POCT is growing in popularity with manufacturers offering a wide menu of tests and devices where the operator can obtain a rapid test result with the potential to initiate faster patient care decisions. But POCT is not fool-proof, and any test can and will fail if operated under the wrong conditions. Methods: Risk management is a process where laboratories can assess their weaknesses, implement a control plan to detect and prevent erroneous results, and monitor the effectiveness of their plans.
Results: The Clinical and Laboratory Standards Institute CLSI EPA: Quality Control Based on Risk Management provides guidance based on risk management for laboratories to develop quality control plans tailored to the particular combination of measuring system, laboratory setting, and clinical application of the test. Discussion: This presentation will describe how laboratories can partner with manufacturers to conduct risk assessments and implement quality control plans in their laboratory and at the point-of-care.
The advantages of utilizing a risk management approach to controlling laboratory errors will be emphasized along with the efficiencies gained from conducting a risk assessment and implementing a quality control plan. A revision of CLSI EPA is currently being drafted, and this presentation will preview a few of the updates that can be expected in the next version of the guidance document. Evidence based laboratory medicine EBLM focuses on the use of diagnostic tests to improve patient outcomes.
POC are tests conducted near the site of patient care, outside of the laboratory, usually performed by patients or clinical personnel not trained in laboratory medicine. POCT require small sample volumes, minimize pre-analytical errors, and reduce alterations of labile analytes.
However, when used appropriately, could improve the patients outcomes by providing faster results and earlier therapeutic strategies 2. Instead, its over or incorrected use could leads a patient risk and potential increase of healthcare costs. We assessed, through a systematic review of the recent scientific literature, the accuracy of the POCT on troponin, procalcitonin, C-reactive protein, parathyroid hormone, INR and d-dimer, and evaluate the impact of faster results on patient management.
Instead, studies on CRP claimed a significant reduction of antibiotic prescription. Several authors evaluated troponin and INR reporting faster decision-making without any improvement in clinical outcome.
Faster results are often translated in better outcomes, without evidence to support this conclusion. So, it is important that the POCT practice is evidence-based looking for evidence of whether POCT confers any advantage in clinical decision making in different scenarios.
In some settings, such as rural environment, a rapid availability of cardiac troponins or other analytes can help clinicians to rule out or rule in disease, without transfer patient in other center, avoiding unnecessary costs 3. Likewise, in Emergency Department, availability of more rapid results with POCT help clinicians to refer patients, but does not always translate into shorter stays 4.
The satisfactory analytical performance, together with an excellent practicability, suggest that the POCT represents an important technological advance in patient care, but, the lack of evidence about the patients outcome invite healthcare workers to use it with judgement.
Price CP. Point of care testing. BMJ ; — Ann Clin Biochem. Arch Pathol Lab Med. Alter DN. Arterial and venous blood gas analysis reveals oxygenation and acid-base status of the body.
Hemoximetry is recommended to determine the impact of dyshemoglobins on oxygenation. Some calculated values may be in error, e. Moreover, the presence of high concentration of fetal hemoglobin may also be a problem if blood gas analyzer does not detect it, as instrument assumes hemoglobin to be of the adult type, and therefore the calculated blood gas oxygen saturation values are underestimated.
In critically ill patients many other analytes have been used to estimate the severity of disease and try to prognosticate morbidity and mortality. No measurements can encompass the complexity of a disorder, but lactic acid can approach that goal 3 Indeed lactic acidosis is the most frequent metabolic acidosis and many causes are reported for lactate increase, not only hypoxia: the higher the lactate concentration, the worse the outcome.
The initial values have a prognostic significance, but serial measurements are more valuable for prognosis. Conductivity-based Hematocrit Ht estimations have limitations. Abnormal protein concentration will change plasma conductivity. Low protein concentration, resulting from dilution of blood with protein-free electrolyte solution during surgery, will result in erroneously low Ht value.
In any situation, to correctly interpret BGA results history should be always considered: reasons for presentation, information concerning events, environment, trauma, medications, poisons, toxins and an accurate physical examination should be carefully collected. Acute respiratory distress syndrone: the berlin definition, Ranieri MV et al. Conductivity-based Hematocrit measurement during cardiopulmonary bypass.
Steinfelder-Visccher J et al. The knowledge that has been garnered so far on severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 infection is that humoral immunity encompasses the generation of immunoglobulins of most classes against surface viral antigens, which mostly involve the spike protein, the nucleocapsid protein, but also envelope and membrane proteins.
Since the spike protein is the anchor that the virus uses for penetrating the host cells through biding with its natural host cells receptors, it can be assumed that antibodies binding to spike protein of SARS-CoV-2, and especially to its receptor binding domain, would retain stronger neutralizing potency against the virus. Serological testing has been conventionally defined as a diagnostic procedure used for detecting an immune response against an infectious agent.
The diagnostic sensitivity stratified according to the assay methodology is highly variable. Additionally important drawbacks of rapid serological tests include the facts that the information provided by the companies is concerning because often lacks details, its quality is considerably variegated among different devices, several claims are vague, there is a lack of transparency along with the fact that human aspects are not been adequately addressed for purpose of alleviating the risk of inappropriately using the device.
The risk of misinterpreting tests results by patients when rapid kits are used for self-diagnosis is another aspect that must be considered. This was mostly due to objective difficulties encountered by the patients in reading and interpreting the results of the strips. Important considerations for implementing point-of-care serology testing thus include i usage of well-validated tests, evaluated against a gold standard; ii performance characteristics – thus encompassing sensitivity, specificity, positive and negative predictive values or cross-reaction with other coronaviruses – shall be tested using serum samples collected from patients infected with SARS-CoV-2, with other respiratory viruses including seasonal coronaviruses and also from healthy controls; iii adequate training of healthcare workers is needed iv and, finally, IV provisions must be in place, encompassing the capture of testing data for individual patient records and surveillance purposes, and the participation to external quality assessment schemes, to systematically monitor the quality of this type of testing.
At the heart of society 4. It is in these sectors that, lately, the greatest investments have been made in digital transformation aimed at exploiting -through data-all the new present and emerging technologies, from the Internet of Things IoT to Artificial Intelligence AI.
The exploitation of Big Data, in fact, constitutes the starting point and the indispensable resource for the development of innovative and precision medicine, providing scientific, organizational and infrastructural support to promote research and accelerate preclinical and clinical studies.
However, this development, having increased the number of subjects holding health-related data, the speed of transmission of such data and the quantity of information electronically stored often not on national territory , has determined an exponential increase in the danger of data processing from the point of view of confidentiality and an increased possibility of damaging the dignity and fundamental freedoms of the individual.
This has led to an increased sensitivity of the European legislator and, subsequently, of the national legislator, towards the protection of such data and related protections. In addition to the General Data Protection Regulation, which has revolutionized the way of conceiving the data economy, it is, in fact, being evaluated by European institutions the first draft of the Artificial Intelligence Act, which will be the real springboard for the massive and regulated use of algorithms, especially in healthcare.
To be precise, this last mentioned regulation will only define the limits to the use of algorithmic systems already widely in use. AIFA, through this guide, has described some case studies, showing some workflows that represent the regulations impacted depending on the type of system used and paying particular attention to the compliance related to the treatment of data and the related profiles of cybersecurity.
Ad oggi sono operativi circa 72 Drive-Through-Difesa. I contributi, forniti da ciascuna Forza Armata, sono diretti e coordinati fin dalla prima ora dal Comando Operativo di vertice Interforze COI per mezzo di una Sala Operativa dedicata, composta da personale interforze. In the last couple of decades, Laboratory Medicine has made giant steps forward in terms of innovative technology and has made major scientific breakthroughs in the medical field as a whole.
Indeed, a plethora of both in vitro and in vivo assays and tests in biological fluids of the human hydrodynamic system are now available. The importance, for clinical purposes, of novel metabolic processes and protein cross-talk mechanisms is being increasingly recognized. The increased survival period of sick, elderly people, plus the therapeutic aspects of precision medicine, in which the drugs selected resulted in a series of direct approaches to altered target molecules, have made it difficult to identify the most effective molecules to use as biomarkers in most of this population scenario.
Therefore, it seems that Laboratory Medicine does not need to increase further value in the contribution to the care of fragile individuals, and in people affected by chronic degenerative diseases. Notwithstanding all these premises, and the increase in Clinical Laboratory testing, which is, and will continue in the future to be an indispensable ally of medical care, the correct diagnosis of a single or of multiple diseases occurring in a single individual will benefit enormously from this Discipline, if some steps forward will be made.
I believe that the enormous amount of knowledge now accumulating in the field of Laboratory Medicine will revolutionize, not only the medical care of people, but, in the various areas of the medical scenario, also the field of Laboratory Medicine Science itself and the practice deriving from it.
In other words, we should all begin to be mindful of our state of health as early as about 20—25 years of age, when most auxological aspects have been reached, and sexual maturity completed. Therefore, also healthy people should be monitored as well as patients, which should be one of the tenets of preventive medicine. Having said that, I must now say that chronological age is practically meaningless in calculating health status.
This, of course, applies much more to multimorbidity; in fact, once identified them, measures can be made to eradicate or to delay the start or the progression of each illness, therefore determining a better state of health during the progression of chronological age.
The revolution I am talking about is to look at each individual when they are enjoying still normal health, as mentioned above.
This approach may be considered too costly, but in effect it is much less costly than waiting for the appearance of an overt disease, which must then be treated for decades, frequently with very expensive drugs and tests laboratory and imaging. This will also support the joining of Preventive Medicine to effective Individualized Medicine. Salvatore F. The shift of the paradigm between ageing and diseases. Clin Chem. Lab Med. Hyperacute myocarditis was reported in Among fulminant cases, most frequent irAEs were interstitial lung disease , colitis , hypothyroidism , and myocarditis Other co-occurring irAEs were colitis-hepatitis-thyroiditis, and arthritis and psoriasis.
Our network approach may complement traditional disproportionality analyses in pharmacovigilance for a more effective signal detection technique, thus supporting regulatory and clinical monitoring, especially in complex scenario such as oncology. Target Oncol ; — Oncologist ; — Hyperacute toxicity with combination ipilimumab and anti-PD1 immunotherapy. Eur J Cancer ; — Introduction: The prolongation of the QT interval is a serious and potentially fatal adverse reaction that has led to the discontinuation of many drugs including some opioids.
Data mining on pharmacovigilance databases can detect signals that identify early the risk associated with some drugs. Results: A total of drug-reaction pairs was found in opioid reports. Analysis of individual opioids show significant signals for QT prolongation for each drug.
The temporal evolution of the different signals according to the number of reports included from to shows early significant positivization of signals in the first 6 to 12 months. Underlying mechanism is unknown, but it seems to be linked to hERG channel blocking. We propose the evaluation of the trend of change in the confidence intervals of the disproportionality parameters as a measure that can predict the occurrence of clinical events at the population level and a posible usefull strategy to minimize adverse reactions.
Introduction: Language and speech are increasingly debated as potential markers for diagnosing and monitoring patients with affective and psychotic disorders 1—3. However, many neglected factors may confound communicative atypicalities.
A comprehensive list of potential confounding drugs will support the design of robust communicative marker studies. Objective: We aim at identifying a list of drugs potentially associated with speech and language disorders, within psychotic and affective disorders. Within the FAERS, we considered separately 3 populations psychotic, affective and non-neuropsychiatric disorders , to account for the confounding role of different underlying conditions.
Robustness analyses were performed to account for the biases. Results: We identified a list of potential expected and 91 unexpected confounding medications for the identification of communication markers of affective and psychotic disorders e. We developed also a MedDRA query proposal for speech and language conditions, formalization of possible biases, and related analyses to account for them.
Conclusion: We provided a list of medications to be accounted for in future studies of communicative bio-behavioral markers in affective and psychotic disorders. The methodological procedure we developed does not simply facilitate future investigations of communicative biomarkers in other conditions, more crucially it provides a case-study in more rigorous procedures for digital phenotyping in general.
Insel TR. Automated assessment of psychiatric disorders using speech: A systematic review. Laryngoscope Investigative Otolaryngology. Voice patterns in schizophrenia: A systematic review and Bayesian meta-analysis. Schizophr Res. Introduction: The comparison of safety profiles for products recently on the market is difficult. There is a lack of methodology for quantifying the potential differences between products that have the same indication.
Objective: Provide the tools to quantify the differences in spontaneous reporting between two products. An Euclidian distance from the EBGM to the diagonal line measures the deviation from what would have been expected under the null assumption of similar safety profiles.
As the deviation does not capture the statistical uncertainty around the estimate, we propose as measure of the deviation the minimal distance of the four Euclidian distances calculated from each of the credibility intervals around the EBGM post Product A and Product B.
A visualization capturing the global trend of the most substantial differences in reporting was generated. Conclusion: This relatively simple method can provide quantification of the differences in reporting and could help prioritize one product over the other for some population subgroups. Introduction: The application of text mining approaches to identify adverse events AEs from electronic health records EHRs is a growing area of interest in pharmacovigilance research.
In veterinary medicine, the majority of EHRs consist of unstructured clinical narratives, hence the development of appropriate methods for identifying AEs of interest is an important step in the research process. Identifying renal disease poses a specific challenge as the event may be described in narrative form or implied by reported test results or the use of renal disease specific medications. In this study we developed regular expressions regexes to identify relevant mentions of renal disease in veterinary free text clinical narratives.
Objective: To develop a method for identifying veterinary patients with renal disease in free text clinical narratives. Methods: Using VeDDRA terminology as a starting point, we used an iterative approach to develop a series of regexes which were then applied to a random sample of 10, clinical narratives.
In order to measure precision, clinical narratives containing a match to the regexes were reviewed against a case definition by two independent reviewers and disagreement was settled by consensus. Terms in the final regex were derived from three sources—VeDDRA, a word embedding model and expert opinion. To determine recall, the final regex was applied to a sample of consults where the main presenting complaint was deemed to be renal disease by a veterinary clinician.
Expanding this terminology using a word embedding model improved the PPV to 0. Following changes suggested by a veterinary expert, the PPV of the final regex was improved to 0. When the regex was divided into three components, the PPV for these individual portions was mentions of renal disease 0.
When compared against the veterinary clinician validated sample of renal disease consults recall was 0. Conclusion: The developed regex can be used to identify animals with renal disease, with mentions of renal disease treatment being the most specific indicator of clinical disease.
This method can be employed to filter potential cases of interest from large datasets for use in observational studies.
Introduction: We use AI in our everyday lives probably without even realising it. There are many discussions about the use of AI in PV and the potential innovation that it could bring but given the conservative nature of our business and having to work in a highly regulated environment, how can we build confidence to get us over that barrier.
Will having the regulators use the same AI make us more comfortable or will legislation be necessary to drive us forward? Objective: Explore why PV has lagged behind with AI technology that is commonplace in other parts of our lives and business. Aspects of AI, such as machine learning, are used in areas such as early disease prediction, clinical diagnosis, outcome prediction and prognosis evaluation, personalized treatments, drug discovery, manufacturing, clinical trial research, and more.
In our personal lives, services like Amazon and Google use AI to understand and target their customers and we accept that as normal. The objective of this presentation is to explore the reluctance of accepting AI in PV and how we can move towards overcoming those obstacles. We will look at some real-life practical examples where AI in PV has worked and what it took to get there.
Conclusion: We will show that the practical application of AI is achievable and has been achieved in the high volume environment of a regulatory authority. Many of the AI features used by the RA, and the lessons learned from that project, can also be applied in industry, so why are we waiting? Introduction: Access to case narratives during signal assessment is crucial to provide a more complete picture of the cases [1], however patient confidentiality needs to be considered.
Sharing of narratives while preserving privacy requires de-identification—the removal or replacement of personal identifiers. Automating this task can help with increasing data load. To ensure patient confidentiality throughout the full pharmacovigilance process, the narratives should be de-identified early in the process.
Person names—one of the more common identifiers in case narratives—can lead to in- direct identification of patients but are challenging to recognise in free text. Objective: To develop and evaluate a method for automated de-identification of names in case narratives.
Methods: We use an ensemble of BERT [2]—a state-of-the-art language model using deep-neural network—combined with hand-engineered rules for detecting names.
Our model is trained on i2b2 deidentification challenge data [3] combined with unprocessed data from the Yellow Card system[4] provided by the MHRA. Because names are rare in the Yellow Card data, the training dataset is prepared using active learning through an independent model. Model testing is done on a separate, manually annotated dataset. Evaluation of the deidentification is guided by: 1 how often clinically relevant information is removed and 2 how identifiable the narratives that the model fails to completely de-identify are.
We define three categories of identifiability: a Directly identifiable, where subject identification is very likely with the leaked information e. Results: Out of the 71 narratives with names and initials, only 12 contained occurrences missed by the system.
Manual evaluation found only one directly and one indirectly identifiable narrative due to leaks. It should be noted that the leaked direct identifier was a foreign, non-English name. A single narrative may contain multiple occurrences of names, the table presents results per occurrence.
Conclusion: Automated de-identification of names is possible without compromising clinically relevant information. Our method can recognise and mask a vast majority of names and most initials while leaving most of the information untouched. Qualitative evaluation shows that the rare leaks that occur tend not to make cases identifiable. Clinical stories are necessary for drug safety.
Clin Med. J Biomed Inform. Medicines and Healthcare products Regulatory Agency. The Yellow Card scheme: guidance for healthcare professionals, patients and the public [Internet]. Introduction: Metronidazole is a nitroimidazole antibacterial drug that is mostly used to treat anaerobic bacteria and protozoa infections. The adverse side effects of metronidazole include gastrointestinal upset, metallic taste, urticaria, headache, peripheral neuropathy. Metronidazole-induced pancreatitis has been rarely described in the literature so far.
Objective: We report a rare case of an acute pancreatitis associated with metronidazole which occurred as a result of a prescription error.
Methods: This case was reported in February to The National Centre of Pharmacovigilance and evaluated according to the updated French method of causality assessment. Results: A year-old male patient with a past medical history of chronic viral hepatitis B treated with entecavir since , presented to the surgery department with an acute onset of a severe epigastric pain radiating through to the back associated with hepatic colic with nausea and vomiting.
On exam, he had severe epigastric tenderness. Relative negatives in the history included, no lithiasis, no known drug allergies, and no alcohol consumption. Patient symptoms and lipase improved within 3 days after metronidazole withdrawl and initiation of supportive care.
Conclusion: The likelihood of metronidazole as the incriminating agent was likely in front of a suggestive delay and favorable outcome after the drug withdrawl. It was suggested a the possible dose-response mechanism between metronidazole use and occurrence of pancreatitis, and this case draw attention to the possible acute pancreatitis associated with metronidazole due to a prescription error.
Metronidazole-associated pancreatitis. Introduction: The possibilities of using current scientific principles to create tools to help give efficiency and help to nurses thereby reducing stress and the potential for errors.
Also enable patients to maintain independence and less outside contact as technology is used to expand the reach of telehealth. Solutions will be adaptable for independent use by the sight, hearing and mentally challenged. The 1st hurdle is to make it easier for patients and staff to accomplish what they have to do safely and consistently. Objective: To simplify the taking of all drugs and supplements using IoT technology.
This a paradigm shift from the many efforts to mitigate the challenges of the many aspects of drug delivery. Here medication is always kept in the labelled, legal safety of the original dispensed container until consumed. Safety concerns of pre-pouring will no longer exist. Authentic real-tine medication usage data will be available. ISoP and other safety management organizations will be able to execute many tasks with precision. Methods: The innovation is a multi-compartment device that holds a medication container in each compartment.
The device has a display that resides in the lid or may be at the front of a drawer type or wall mounted unit. The concept of assigned location forms the basis for these innovations. Stored instructions for many aspects of care and follow-up resides in the device and will be communicated via the display appropriately. It can be connected to a larger display, cellphone or other mobile device. Medicine containers are scanned to capture dosing instructions.
The assigned location lights up. The container is placed within the compartment and receives an alert at dosing times. The compartment stays lit until the nurse picks up and replaces the container. Video may be activated. Biometric access ensures identity and pill count and time are automatically recorded.
Results: Feasibility indicates that the must touch to silent feature is a powerful feature that aids adherence. Also the timing methods that ensures safe dosing separation helps to ensure all doses are taken in a given day even if late taking a dose. Relative time rather than time of day dosing is used.
Conclusion: Believed to be unsolvable, these discoveries will open the door to the science of individual ingestion by effortlessly notifying and guiding individuals in the consumption and effects of medicines and other items for a safer and healthier life experience.
Powerful data will be generated for use by ISoP. Introduction: The Summary of Product Characteristics for Ceftriaxone states that as with all beta-lactam antibacterial agents, serious and occasionally fatal hypersensitivity reactions have been reported [1].
However, the frequency is stated as unknown. Out of 46 reports to Ceftriaxone in the Uganda ADR database, 7 of these are of anaphylactic reactions, and one of them was fatal for the paediatric patient. It is not clear in cases of injurious or fatal drug effects who should bear the liability. Objective: To present a case study of a successful legal resolution of a fatal medication error to Ceftriaxone with the involvement of the regulator.
Methods: This is a retrospective case report. Results: A one-and-a-half-year-old male child was diagnosed with septicaemia with diarrhoea and admitted to a hospital. Day one treatment with Ceftriaxone was stopped due to a reaction of difficulty in breathing. A switch to Ciprofloxacin happened and the patient began to improve. Due to a weekend staff shift change, the change to ciprofloxacin was not noted resulting in re-administration of ceftriaxone and anaphylaxis that caused the death of the patient despite all efforts to resuscitate.
National Drug Authority performed a causality assessment of the serious adverse event and found that administration of Ceftriaxone was related to the outcome of death. However, it was noted that this was a medication error with no malice aforethought and therefore the health care provider was not liable. Publication of these results can aid in encouraging reporting rates among patients and providers. Ceftriaxone 1g Powder for solution for injection. Accessed March 9, General characteristics, economic burden, causative drugs and medical errors associated with medical damage litigation involving severe cutaneous adverse drug reactions in China.
Journal of Clinical Pharmacy and Therapeutics. Liability associated with prescribing medications. Primary care companion to the Journal of clinical psychiatry. Bhatt AD. Drug-related problems and adverse drug events: negligence, litigation and prevention. The Journal of the Association of Physicians of India. PMID: Physicians’ liability for adverse drug reactions. Southern Medical Journal. Introduction: Pharmacotherapeutic Follow-up is a professional practice focused on identification, prevention and resolution of Drug-Related Problems and the causes or errors that originate these problems in patients [1—4].
Methods: Clinical pharmacists perform Pharmacotherapeutic Follow-up of hospitalized patients through three evaluations: drug reconciliation, pharmacotherapeutic profile and drug prescription suitability, identifying Drug-Related Problems and medication errors and recording their activities in two databases: the first consists of the evaluation that is carried out weekly and the second corresponds to the pharmaceutical interventions; these bases are validated monthly with each other.
For this study, data is taken from both databases in the period from June to December and the risk that was reduced by accepted pharmaceutical interventions is calculated. Results: In the review of the database of activities carried out, a progressive increase in the number of evaluations done by clinical pharmacists was observed in drug reconciliation, pharmacotherapeutic profile and drug prescription suitability, identifying discrepancies, medication errors and Problems Related to Medications.
In the database of pharmaceutical interventions, a significant increase in the risk that was reduced associated with the interventions carried out and accepted was observed; as it can be identified in figure 1, which ranges from Conclusion: The pharmaceutical interventions allowed to improve the prescriptions and with it, identify Problems Related to Medications and medication errors before causing harm to the patient, making the drugs safer.
Farmacia Hospitalaria, 37 1 , 59— Introduction: Some side effects of anticholinergic drugs can be relatively harmless such as dry mouth or constipation, but in some cases, they can manifest themselves in the form of heart arrhythmias or as worsening of dementia or delirium.
The elderly are more prone to show anticholinergic effects, due to a progressive decrease in acetylcholine levels, and are often also treated with drug polytherapy with additive effects which leads to an anticholinergic cognitive burden ACB [1—4]. Objective: Verify whether it is possible to identify patients who may experience an adverse reaction due to ACB in real clinical practice through a pharmacological investigation, identify which drugs are the possible cause and re-evaluate the therapy to prevent the onset of adverse reactions.
Clinical analysis was performed by assigning a score of 1 to each adverse event attributable to ACB in the central nervous system, mouth, eyes, heart, gastrointestinal tract, bladder, and skin. Results: In 34 patients, the total number of drugs prescribed was with an average of 8.
In these patients, the major drugs responsible for elevated ACB were quetiapine, chlorpromazine, and paroxetine, all three with a value of 3. The 5 patients also showed clinical signs of ACB. Conclusion: Computerized determination of CBA was helpful in preventing adverse reactions, identifying which drugs are responsible for adverse reactions and modifying therapy to avoid the occurrence of adverse events.
Drug therapy analysis is useful in conjunction with clinical evaluation and can be a valuable tool used in conjunction with tools such as Mini Mental Status. A preliminary study of anticholinergic burden and relationship to a quality of life indicator, engagement in activities, in nursing home residents with dementia.
J Am Med Dir Assoc. Epub Jan 9. Epub Jun J Am Geriatr Soc. Epub Aug J Nutr Health Aging. Introduction: Presence of a strong medication safety system can prevent many potential medication errors MEs by enforcing safety monitoring on the ordering, prescription, preparation, and administration of medicines [1].
Furthermore, a well established medication safety system can solve many causes of communication problems which account for over half of all causes associated with medication errors through its electronic based system.
Unfortunately, many of the existing electronic health records EHRs were designed for purposes of medical billing rather than for medical care, resulting in challenges for using the recorded data for safety data capturing. Moreover, commercially available electronic prescribing and computerized physician order entry systems are cost-prohibitive for many health organization, especially non-profit ones.
In a previous research project, Egypt Chapter of International Society of Pharmacovigilance ISoP was engaged in developing such system in the hospital of Palestine Red Crescent Society PRCS in Cairo to support identifying MEs that were experienced by refugees through remodeling and adding new features to the existing hospital management system.
Objective: The objective of this study was to assess the effectiveness of introducing internally low-cost electronic prescription system in reducing the frequency of MEs of different types. Methods: A pre- and post-intervention study was conducted to compare the frequency of MEs before and after replacing the traditionally used paper-based system with an internal electronic-based system in hospital setting.
MEs were collected by reviewing randomized medical records at base line and after one year of introducing this electronic-based system. More focus was given to medical records of elderly patients and emergency ward. The prescribing errors, transcribing errors, dispensing errors, administration errors were investigated.
Results: We analyzed paper-based prescriptions at baseline and paper-based and electronic prescriptions at one year of follow-up. The errors were Conclusion: The adoption of internal electronic prescription systems was effective in markedly reducing the frequency of MEs compared to the paper-based system in a low-resource setting where the expense on complex commercial electronic solutions are burden for institutions.
Elhawary, M. Drug Saf 45, 97—99 Introduction: In spite of its large use, a conspicuous number of paracetamol adverse reaction reports have been recently collected, due to overdosage or posologic mistakes.
A recent metanalysis by BMC Med Inform Decis Mak [1] has inserted paracetamol in the list of the six drugs causing severe ototoxicity and a pharmacovigilance retrospective study [2] has highlighted that it induced 1. Another recent review on the analgesic standard doses of paracetamol has demonstrated its grade of toxicity, at the maximum prescribed dose [3]. Methods: A survey of 7 questions on standard dosage, dose adjustment and antidotes to paracetamol overdose was submitted to 36 health professionals nurses, pharmacists, oncologists, hematologists, surgeons in the Cancer Institute of Bari.
The answers were collected and charted in diagrams, in order to soon identify critical evidences. Conclusion: The collecting data have demonstrated the clinical need to manage accurately old and apparently well-known drugs to grant a controlled clinical risk in hospitals. Pharmacovigilance is a duty for health professionals and the awareness that also old drugs can be causes of toxicity is a substantial starting point for safety of care. Hyunah Shin, Suehyun Lee.
Saudi Pharm. Paracetamol: not as safe as we thought? A systematic literature review of observational studies. Ann Rheum Dis Mar;75 3 —9. Paracetamol: mechanism of action, applications and safety concern.
Acta Pol Pharm. Jan—Feb ;71 1 — Eur J Pain. Introduction: High interest in the last two years was globally put by Health Authorities on the recording, coding, and reporting of medication errors to ensure the safety and effectiveness of the use of medicines and to provide reliable information to healthcare professionals and patients.
Medical coding is a prerequisite for efficient, effective, and reproducible data outputs. Methods: A sample of medication error coding results was assessed for accuracy and consistency of MedDRA coding and identification of main types of coding errors.
Results: One-third of the records could not be assessed due to incomplete or unclear verbatims. In one-third, code assignments were correct, but another third of the sample was not adequately coded. Most frequent coding errors corresponded to vague PT assignments, while more detailed information was available for a more precise coding.
This observation is similar to the EudraVigilance database, where some of the most assigned MedDRA terms for medication errors also represent vague concepts.
Conclusion: These findings indicate that understanding of medication error documentation and assessment and of MedDRA content and coding guidelines need to be reinforced.
Introduction: Pediatric intoxications represent one of the most common causes of harm to children under the age of six and the fourth leading cause of death in developing countries [1—2]. Data collection and systematic analysis of intoxication cases is of fundamental importance to gain a greater knowledge of toxic domestic, environmental and pharmacological agents [4—5].
Gaslini for the period from January to December All poisoning were retrieved from the Hospital Central Database using the International Classification of Disease ICD 9 classification code system, and subsequently entered into a local database for data management. Descriptive statistics were undertaken.
Our analysis included therefore poisoned patient cases, 70 were from females and 74 from males, with a median age of 3 years old. Out of the total of accesses, Poisoning severity and the need for hospitalization have also been investigated. Conclusion: Implementation of high-performance data collection systems in the Emergency Department could be decisive in guiding clinical choices.
This study has gathered data on pediatric poisonings in a regional reality in the absence of a Poison Center. Although preliminary, these findings may guide for the improvement of the surveillance system of intoxications in pediatrics. The burden of unintentional injuries among the under-five population in South Asia. Acta Paediatr.
Sistema informativo nazionale per la sorveglianza delle esposizioni pericolose e delle intossicazioni: casi rilevati nel Decimo rapporto annuale. Surveillance of toxic exposures: the pilot experience of the Poison Control Centers of Milan, Pavia and Bergamo in Ann Ist Super Sanita. Early detection of illness associated with poisonings of public health significance. Ann Emerg Med.
Introduction: While electronic health record EHR is a potentially valuable resource of adverse drug reactions ADRs [1,2], these ADRs are frequently not registered, registered in the wrong place or only registered using free-text entry [3,4]. Free text data cannot be managed and analyzed with mainstream software tools, but this is possible with text mining TM tools.
Methods: In phase I, the previous rule-based algorithm was translated to a R-algorithm and improved it with the help of previous mentioned issues. Conclusion: The developed R-algorithm identified ADRs, however further research is required to extrapolate the algorithm and to combine it with clinical decision support systems to bring the data back to the physician to increase ADR registration. Data processing and text mining technologies on electronic medical records: A review.
J Healthc Eng. Text mining applied to electronic medical records: A literature review. Reasons for discontinuation of medication during hospitalization and documentation thereof: a descriptive study of geriatric and internal medicine patients.
Recurrence of adverse drug reactions following inappropriate re-prescription: Better documentation, availability of information and monitoring are needed. Also know as multicompartment compliance aids, they are devices that allow for medicines to be dispensed into compartments which are separated by days of the week and times of the day.
Methods: A retrospective analysis was conducted on four hundred and eighty-seven adult patients’ hospital admission episodes. Medications most frequently implicated were antidepressants, ACE inhibitors, analgesics, and antipsychotics.
The study highlights that inline with published evidence 5 , the cohort of patients more at risk of DRPs are the older population. Older patients frequently use MDS and are already at risk of DRPs as they frequently have multi-morbidities and polypharmacy 6. This study has highlighted that ongoing measures should be considered to reduce DRPs such as deprescribing and regular medication reviews. It also highlights the importance of engaging with patients and carers to increase medication education and awareness.
Hospitalisations caused by adverse drug reactions ADR : a meta-analysis of observational studies. Pharmacy World and Science. Oswald K. Pill organisers could put older patients at risk of adverse events.
The Pharmaceutical Journal. Drug safety. Polypharmacy and falls in older people: Balancing evidence-based medicine against falls risk. Postgrad Med. Introduction: Amid the recent outbreak, the quality of medical care provided to COVID Coronavirus Disease patients has been deeply impacted as a result of organizational limitations and insufficient medical resources. This complex situation was amplified by additional factors that include the widespread use of experimental drugs, the lack of detailed guidelines and recommendations, and workload increase.
Consequently, COVID patients became more vulnerable to medication errors and adverse drug events, especially in the intensive care units ICUs [1,2]. Objective: To describe the pharmaceutical interventions PIs carried out by a clinical pharmacist and to evaluate their clinical impact. PIs were registered by the pharmacist using the French Society of Clinical Pharmacy’s PI sheet, and their clinical impact was assessed using Hatoum scale 0-to Data of a two-month period, from October to December , were analyzed using Excel.
A median age of Conclusion: The active role of clinical pharmacists in the ICU is well established in the literature. Our study underlines the necessity of clinical pharmacy services in the COVID ICU, which helps in preventing drug errors and providing optimal care to this sensitive population.
Health human resources challenges during COVID pandemic; evidence of a qualitative study in a developing country. On-ward participation of clinical pharmacists in a Chinese intensive care unit for patients with COVID A retrospective, observational study. Research in Social and Administrative Pharmacy ; 1: — Introduction: Antiretroviral Therapy is recommended for all persons living with HIV to reduce morbidity and mortality and to prevent the transmission of the virus to others.
Medications are offered by health services throughout the world, but their use comes with a substantial growing risk of harm [1]. This includes Medication Errors which is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer [2]. They are among the most common medical errors, harming at least 1. Objective: To establish the number of medication errors reported due to look-alike Antiretroviral Therapy amongst adult clients over a 12month period at Mbagathi Hospital Comprehensive Care Center Pharmacy.
Methods: A survey was carried out over a 12month period between January and January to establish the number of medication errors reported due to look-alike Antiretroviral Therapy amongst Adult clients. The results of the study were captured in the medication error reporting forms at the Comprehensive Care Center Pharmacy and in a table indicating the error. Results: Over the 12month period, 2 medication errors were reported due to look-alike Antiretroviral Therapy.
The medication errors reported occurred after two adult clients were dispensed with the wrong medication due to look-alike medications that were stored next to each other on the dispensing shelf. Conclusion: Medication errors were found to have occurred over the 12month survey period. The study was able to confirm that medication errors can occur when staff lack proper training on how to store and dispense look-alike medications. It is therefore important to continuously train staff on appropriate storage and dispensing practices to avoid these medication errors and to have standard operating procedures on how to store and dispense look-alike medications.
After the medication error incident we proceeded to rearranged all the look-alike medications ensuring that they were not stored in close proximity to each other and we also printed bold labels for all the medications on the shelves.
Polypharmacy and medicines optimisation. Making it safe and sound. About Medication Errors. Accessed on Preventing Medication Errors: Quality chasm series.
Introduction: Neuromuscular diseases NMDs involve injury or dysfunction of peripheral nerves or muscles, with pain being a significant problem [1]. Paracetamol is used in patients with NMDs. Ingestion of a licensed dose is not considered an overdose [2]. However, this may not be true in some patients of NMDs with their different pharmacogenetics and phenotypes [3].
Objective: To collate evidence that in patients with NMDs, therapeutic dose of paracetamol might be an overdose leading to toxicity.❿

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