Evaluating pharmacist based medication reconciliation: a literature review and case study

Medication errors are common through all phases of a hospitalization and represent a significant patient safety risk. Medication errors lead to Adverse Drug Events which are the most common type of error experienced in a hospital. Such events represent a significant public health issue and have gained national attention. Despite this attention, the current financial structure of the United States’ healthcare system inhibits providers from fully embracing efforts to reduce medication errors. Medication Reconciliation is the act of completing a medication history and correcting discrepancies between a patient’s previous medication regimen and the proposed medication order. Medication reconciliation characterizes a sustainable solution that can significantly reduce medication errors if performed correctly. Often, medication reconciliation is performed by a nursing admissions team or physicians, despite the research that proves pharmacists are suited best. When pharmacists perform medication reconciliation it denotes the most effective solution for reducing drug related errors. A case study of a large academic medical system’s Emergency Department examined the effectiveness of a nursing based medication reconciliation process. A pharmacist reviewed medication histories performed by a nursing admissions team to assess the prevalence and type of medication discrepancies. Interviews with key stakeholders conveyed the barriers in creating an effective medication reconciliation process

Trends in Percutaneous Coronary Interventions in New South Wales, Australia

This is the first detailed study on percutaneous coronary intervention (PCI) in New South Wales (NSW), Australia. Hospital data for PCIs carried out between 1 July 1990 and 30 June 2002 are analysed. The study explores trends in PCI rates by selected socio-demographic factors, the utilisation of angioplasties vis-a-vis stents, emergency admissions, and selected coexisting conditions which determine the disease status of PCI patients. Logistic regression models are used to study the medical conditions that require both PCI and coronary artery bypass graft (CABG). The PCI rate has grown rapidly at 12.1% per annum, with a particularly rapid increase for persons aged 75+. The rate of multiple stent utilisation increased at 4.6% per annum. Pacific-born and Middle-Eastern-born patients are more than twice as likely as the Australian-born to have diabetes. Factors affecting failure of PCI requiring CABG include perforation and multi-vessel disease. PCI services in public hospitals need to be increased to facilitate the availability of these procedures to all segments of the population, as do targeted community-level programmes to educate high-risk groups in the control of heart diseases

4D Flow cardiovascular magnetic resonance consensus statement: 2023 update

Hemodynamic assessment is an integral part of the diagnosis and management of cardiovascular disease. Four-dimensional cardiovascular magnetic resonance flow imaging (4D Flow CMR) allows comprehensive and accurate assessment of flow in a single acquisition. This consensus paper is an update from the 2015 '4D Flow CMR Consensus Statement'. We elaborate on 4D Flow CMR sequence options and imaging considerations. The document aims to assist centers starting out with 4D Flow CMR of the heart and great vessels with advice on acquisition parameters, post-processing workflows and integration into clinical practice. Furthermore, we define minimum quality assurance and validation standards for clinical centers. We also address the challenges faced in quality assurance and validation in the research setting. We also include a checklist for recommended publication standards, specifically for 4D Flow CMR. Finally, we discuss the current limitations and the future of 4D Flow CMR. This updated consensus paper will further facilitate widespread adoption of 4D Flow CMR in the clinical workflow across the globe and aid consistently high-quality publication standards

Diversity of Transgenic Mouse Models for Selective Targeting of Midbrain Dopamine Neurons

SummaryVentral tegmental area (VTA) dopamine (DA) neurons have been implicated in reward, aversion, salience, cognition, and several neuropsychiatric disorders. Optogenetic approaches involving transgenic Cre-driver mouse lines provide powerful tools for dissecting DA-specific functions. However, the emerging complexity of VTA circuits requires Cre-driver mouse lines that restrict transgene expression to a precisely defined cell population. Because of recent work reporting that VTA DA neurons projecting to the lateral habenula release GABA, but not DA, we performed an extensive anatomical, molecular, and functional characterization of prominent DA transgenic mouse driver lines. We find that transgenes under control of the tyrosine hydroxylase, but not the dopamine transporter, promoter exhibit dramatic non-DA cell-specific expression patterns within and around VTA nuclei. Our results demonstrate how Cre expression in unintentionally targeted cells in transgenic mouse lines can confound the interpretation of supposedly cell-type-specific experiments. This Matters Arising paper is in response to Stamatakis et al. (2013), published in Neuron. See also the Matters Arising Response paper by Stuber et al. (2015), published concurrently with this Matters Arising in Neuron

Diversity of Transgenic Mouse Models for Selective Targeting of Midbrain Dopamine Neurons

Ventral tegmental area (VTA) dopamine (DA) neurons have been implicated in reward, aversion, salience, cognition, and several neuropsychiatric disorders. Optogenetic approaches involving transgenic Cre-driver mouse lines provide powerful tools for dissecting DA-specific functions. However, the emerging complexity of VTA circuits requires Cre-driver mouse lines that restrict transgene expression to a precisely defined cell population. Because of recent work reporting that VTA DA neurons projecting to the lateral habenula release GABA, but not DA, we performed an extensive anatomical, molecular, and functional characterization of prominent DA transgenic mouse driver lines. We find that transgenes under control of the tyrosine hydroxylase, but not the dopamine transporter, promoter exhibit dramatic non-DA cell-specific expression patterns within and around VTA nuclei. Our results demonstrate how Cre expression in unintentionally targeted cells in transgenic mouse lines can confound the interpretation of supposedly cell-type-specific experiments. This Matters Arising paper is in response to Stamatakis et al. (2013), published in Neuron. See also the Matters Arising Response paper by Stuber et al. (2015), published concurrently with this Matters Arising in Neuron

4D Flow cardiovascular magnetic resonance consensus statement: 2023 update

Hemodynamic assessment is an integral part of the diagnosis and management of cardiovascular disease. Four-dimensional cardiovascular magnetic resonance flow imaging (4D Flow CMR) allows comprehensive and accurate assessment of flow in a single acquisition. This consensus paper is an update from the 2015 ‘4D Flow CMR Consensus Statement’. We elaborate on 4D Flow CMR sequence options and imaging considerations. The document aims to assist centers starting out with 4D Flow CMR of the heart and great vessels with advice on acquisition parameters, post-processing workflows and integration into clinical practice. Furthermore, we define minimum quality assurance and validation standards for clinical centers. We also address the challenges faced in quality assurance and validation in the research setting. We also include a checklist for recommended publication standards, specifically for 4D Flow CMR. Finally, we discuss the current limitations and the future of 4D Flow CMR. This updated consensus paper will further facilitate widespread adoption of 4D Flow CMR in the clinical workflow across the globe and aid consistently high-quality publication standards.ISSN:1097-6647ISSN:1532-429