Detection of anticoagulant medication errors by triggers

Background. Medication errors can cause preventable adverse events. For example, inappropriate use of anticoagulants (AC) can result in bleeding and thromboembolic complications. Detection and analysis of AC medication errors allow to reveal deficiencies in the safety systems in healthcare organizations. Aim. The study was aimed to develop a method of systematic detection of anticoagulant medication errors for consequent audit, analysis and development of medication safety improvement measures. Materials and methods. The study was conducted in the multidisciplinary hospital and included 4924 patients admitted from January 2019 to December 2021 who received AC. Three laboratory triggers (international normalized ratio ≥4, serum creatinine ≥133 μmol/l, and glomerulofiltration rate 30 ml/min/1.73 m2) helped to reveal 4304 cases. Their matching with patient’s data helped to develop combined triggers. Two clinical pharmacologists reviewed all cases identified by combined triggers for checking medication errors. The trigger was considered positive when anticoagulant medication error was detected in the history selected by combined trigger. Results. Of the 4924 patients 253 (5.3%) were selected by combined triggers. Combined trigger allowed to reduce the amount of medical health records audit by 97.3%. Medication errors were detected in 137 patients. Positive predictive value of selected combined triggers varied from 0 to 63.9%. Aggregated positive predictive value of all combined triggers amounted to 54.2%. AC medication errors were detected in 2.8% patients. Conclusion. Method of systematic detection of AC medication errors using combined triggers in all hospitalized patients receiving AC allowed to reveal typical medication errors for consequent analysis and elaboration of measures to reduce preventable patient harm in healthcare settings

AUTOMATIC DETERMINING OF TOKEN SEQUENCE ERRORS IN RESPONSES TO OPEN ANSWER QUESTION IN MOODLE LMS

The paper reviews the problem of automatic analysis, grading and hinting to the student in the questions, where correct answer must be the correct sentence in the target language in which order of words (tokens) is important. Proposed solution consists of combination of lexical analysis and editing distance analysis. Proposed solution was implemented as a CorrectWriting question type to a popular Moodle LMS. Such question type is useful when teaching programming languages and English as foreign language

Analysis of the composition of hospitalized patients with the new coronavirus infection COVID-19

Introduction. In the context of the growing epidemic of the new coronavirus infection COVID-19, the Russian health system, for the first time in recent history, faced the need for large-scale mobilization and conversion of many existing hospitals into infectious diseases hospitals. At the same time, the composition of hospitalized patients has not been studied, and the availability of data on it is crucial for the organization and planning of medical care. Purpose of study. To study the composition of hospitalized patients with a new coronavirus infection COVID-19 from the point of view of their age, gender, the severity of the condition, the presence of pneumonia and concomitant diseases to optimize the planning and objectification of the assessment of the need for medical care in a hospital setting. Material and methods. The data was studied, and the analysis of hospitalizations of 1037 patients in the country’s largest repurposed infectious hospital for the treatment of patients with the new coronavirus infection COVID-19 was carried out. Results. For the first time analyzed the main regularities of the formation of hospitalized patients, which characterize features of the disease and have a high prognostic value both from the point of view of organization of specialized medical care in stationary conditions and assess the need for diagnostic and diagnostic and treatment activities and their resource provision. It is established that adult patients of almost all age groups receive medical care in a hospital setting, but as the age increases, the need for hospitalization tends to increase. Conclusions. The severity of hospitalized patients with COVID-19 is determined by their age and the presence of concomitant pathology, which is of important prognostic value from the point of view of optimal planning of this type of medical care.</jats:p

ADME pharmacogenetics: future outlook for Russia

This systematic review reflects the results of pharmacogenetic studies in the Russian Federation aimed at studying the genes involved in the drug biotransformation system. The works of Russian researchers found by us are mostly devoted to microsomal liver oxidation enzymes (metabolism) and membrane transporter systems (absorption and excretion). This review presents population-ethnic and associative clinical studies on the genes of the CYP450 system, noncytochrome oxidation enzymes ( SULT1A1, CES1), membrane transporter system genes ( ABCB1, SLCO1B1) and warfarin biotransformation enzymes ( VKORC1, GGCX). The information is structured in the form of 11 tables, divided by regions of the Russian Federation. </jats:p

Methotrexate Safety in Psoriasis: An Overview

Methotrexate is a highly efficacious treatment for psoriasis, but the use of methotrexate may be limited by concerns regarding its adverse reactions. On average, 28.3 % of patients with psoriasis treated by methotrexate develop adverse reactions. The occurrence of adverse drug reactions in some cases leads to the therapy discontinuation, which may be accompanied by psoriasis exacerbation. The purpose of this article is to provide an extensive review of the methotrexate efficacy, safety and tolerability as well as provide a comprehensive understanding of methotrexate pharmacokinetics and pharmacodynamics, methotrexate side effects pathogenesis, approaches to methotrexate safety monitoring, situations in which it is necessary to be vigilant when prescribing methotexate. We also outline current data concerning methotrexate molecular mechanism of action, including new data on its anti-inflammatory activity, that allow us to explain the pathogenesis of a number of adverse drug reactions, as well as discuss possible ways of predicting the methotrexate toxicity, especially focusing on recent advances in the field of pharmacogenetics of methotrexate-induced toxicity and personalized approach to psoriasis treatment.</jats:p

Endocrine ophthalmopathy: pharmacogenetic markers of efficiency of glucocorticoid therapy

The pathological process of endocrine ophthalmopathy is based on damage to the soft tissues of the orbit against the background of impaired thyroid function and even its euthyroid state. The pathogenetic mechanisms of the development of clinical symptoms of endocrine ophthalmopathy (EOP) are based on morphological changes in extraocular muscles (EOM) and orbital tissue: cellular tissue infiltration by representatives of the immune system (T- and B-lymphocytes, macrophages, mast and plasma cells), with the production of pro-inflammatory cytokines, fibroblasts and glycosaminoglycans, contributing to an increase in the contents of the orbit in volume with the development of exophthalmos and tissue fibrosis at the end of the inflammatory process. Glucocorticoids are the gold standard for the pathogenetic treatment of patients with clinical forms of endocrine ophthalmopathy: edematous exophthalmos and endocrine myopathy. The properties of drugs of this group are such that they can be used to suppress all stages of inflammation in the orbital tissues, preventing the progression of the disease. Despite the many years of experience in applying various glucocorticoid therapy techniques, to date there are no uniform criteria for the effectiveness of this treatment in patients with endocrine ophthalmopathy. The article presents the features of glucocorticoid therapy of endocrine ophthalmopathy, as well as literature data, on the basis of which attempts have been made to explain the causes of glucocorticoid resistance taking into account the pharmacogenetic profile.</jats:p

DEFINITION OF TYPOS IN ANSWER OF STUDENT IN KNOWN CORRECT ANSWER

The paper describes method of typo detection in the answers for the questions with open answers. In such questions we know one or several correct answers defining relatively small dictionary of correct words contrasting the usual case of looking for typos in arbitrary text. This fact allows using more complex analysis methods and finding more possible typos, such as extra or missing separators. A typo correction module for the Correct Writing question type (for Moodle LMS) was developed using proposed methods

Personalized medicine: myth or reality? The position of Russian clinical pharmacologists

A personalized medicine, a recent trend of clinical pharmacology, makes possible the individual approach to the choice of the drugs and their dosage. According to the results of a study of the activity of different biomarkers, particularly the isoenzymes of the cytochrome P-450, they provide the efficiency and safety of the pharmacotherapy. The activity of the isoenzymes of the cytochrome P-450 determines an individual pharmacological response and depends on many factors, including genetic ones. The biomarkers of the activity of the isoenzymes of the cytochrome P-450 should be tested in the clinical practice settings using the simple and cheap methods, one of the most available is an immunofluorescent assay. The skilled staff and the centers of personalized medicine are necessary for this approach