Registration errors among patients receiving blood transfusions: a national analysis from 2008 to 2017.

BACKGROUND AND OBJECTIVES: The key first step for a safe blood transfusion is patient registration for identification and linking to past medical and transfusion history. In Canada, any deviation from standard operating procedures in transfusion is an error voluntarily reportable to a national database (Transfusion Error Surveillance System [TESS]). We used this database to characterize the subset of registration-related errors impacting transfusion care, including where, when and why the errors occurred, and to identify frequent high-risk errors. MATERIALS AND METHODS: A retrospective analysis was conducted on transfusion errors reported to TESS by sentinel reporting sites relating to patient registration and patient armbands, between 2008 and 2017. Free-text comments describing the error were coded to further categorize into common error types. The number of specimens received in the transfusion laboratory was used as the denominator for rates to allow for comparison between hospital sites. RESULTS: Five hundred and fifty-four registration errors were reported from 10 hospitals, for a global error rate of 5·4/10 000 samples (median 5·0 [interquartile range 3·7-7·0]). The potential severity was high in 85·7% of errors (n = 475). The patient experienced a consequence in 10·8% of errors (n = 60), but none resulted in patient harm. Rates varied widely and differed by nature across sites. Errors most commonly occurred in outpatient clinics or procedure units (n = 160, 28·8%) and in emergency departments (n = 130, 23·5%). CONCLUSION: Registration errors affect transfusion at every step and location in the hospital and are commonly high risk. Further research into common root causes is warranted to identify preventative strategies.

Efficacy and safety of sacubitril/valsartan in the treatment of middle-aged and elderly patients with hypertension: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: With the increase of hypertensive patients worldwide, the need for better antihypertensive drugs to achieve blood pressure standards and reduce complications is of great clinical significance. As an angiotensin receptor-neprilysin inhibitor, sacubitril/valsartan has been widely used in the treatment of heart failure, but its efficacy and safety in the treatment of middle-aged and elderly hypertensive patients are still controversial. Therefore, we performed a meta-analysis to compare the efficacy and safety of sacubitril/valsartan and other antihypertensive drugs in the treatment of middle-aged and elderly patients with hypertension. METHODS: The databases of PubMed, Embase, and Web of Science were systematically searched from their establishment to February 2022 to collect the randomized controlled trials (RCTs) of sacubitril/valsartan and other antihypertensive drugs in the treatment of middle-aged and elderly hypertensive patients. The Cochrane Collaboration's tool was used to assess risk of bias for included studies, and the meta-analysis was performed by using RevMan 5.3. RESULTS: In all, 7 studies which met the criteria were included, with a total sample size of 3,323 patients, including 1,899 patients treated with sacubitril/valsartan, and 1,424 patients treated with angiotensin II receptor blockers (ARBs). The meta-analysis showed that compared with other antihypertensive drugs, sacubitril/valsartan can significantly reduce mean reductions in sitting systolic blood pressure [mean difference (MD) =-4.70, 95% confidence interval (CI): -5.79 to -3.61, P<0.001], mean reductions in sitting diastolic blood pressure (MD =-2.29, 95% CI: -2.53 to -2.04, P<0.001), 24-hour mean reductions in ambulatory systolic blood pressure (MD =-3.36, 95% CI: -4.08 to -2.64, P<0.001), and 24-hour mean reductions in ambulatory diastolic blood pressure (MD =-1.49, 95% CI: -1.99 to -0.99, P<0.001), while there was no significant difference in the incidence of adverse events [odds ratio (OR) =1.14, 95% CI: 1.00 to 1.31, P=0.06], serious adverse events (OR =1.06, 95% CI: 0.64 to 1.76, P=0.81), and discontinuations due to adverse events (OR =0.86, 95% CI: 0.51 to 1.46, P=0.58). DISCUSSION: Compared with other antihypertensive drugs, sacubitril/valsartan may be more effective in lowering blood pressure, and its safety may be comparable to that of ARBs. However, these results have to be confirmed by future RCTs with larger sample sizes and higher quality, and the long-term benefits of sacubitril/valsartan require further observation.

[Application of endovascular embolization for brain arteriovenous malformation].

Endovascular embolization has increasingly been applied for brain arteriovenous malformation (BAVM). With our better understanding of BAVM and the continuous improvement of micro-catheter technology and embolic materials, the therapeutic effectiveness has constantly increased. This paper reviews recent advances in research on BAVM and the application of endovascular embolization.

Efficacy and safety of endovascular coiling vs surgical clipping for patients with ruptured carotid-ophthalmic aneurysm: A protocol for systematic review and meta-analysis.

BACKGROUND: Carotid-ophthalmic aneurysms are relatively rare, and represent 1% of all intracranial aneurysms. Generally, endovascular coiling and surgical clipping are the 2 most commonly used methods to treat ruptured carotid-ophthalmic aneurysms, it provides the most favorable outcome for a patient. This study aims to assess the efficiency and safety of endovascular coiling vs surgical clipping for patients with a ruptured carotid-ophthalmic aneurysm. METHODS: A comprehensive systematic literature review was done in PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), and WanFang databases. Only randomized trials that compared endovascular coiling with surgical clipping in patients with ruptured carotid-ophthalmic aneurysm was included. Data was extracted independently by 2 review authors. Moreover, the quality of study and bias risk was evaluated by utilizing an appropriate method. Triallists will be contacted to acquire missing information. The data is presented as risk ratio and mean difference, or standardized mean difference with 95% confidence intervals. RESULTS: The results from the present research shall be published in a peer-reviewed journal. CONCLUSION: The present study summarizes the direct and in-direct evidence to judge the efficiency and safety of these 2 methodologies to treat ruptured carotid-ophthalmic aneurysms and attempt to find the most efficiency and safety therapeutical method. ETHICS AND DISSEMINATION: The present study is a meta-analysis based on published evidence. As a result, ethics approval and patient consent are not needed.

Gender differences in physical aggression: A prospective population-based survey of children before and after 2 years of age.

There has been much controversy over the past decades on the origins of gender differences in children's aggressive behavior. A widely held view is that gender differences emerge sometime after 2 years of age and increase in magnitude thereafter because of gender-differentiated socialization practices. The objective of this study was to test for (a) gender differences in the prevalence of physical aggression in the general population of 17-month-old children and (b) change in the magnitude of these differences between 17 and 29 months of age. Contrary to the differential socialization hypothesis, the results showed substantial gender differences in the prevalence of physical aggression at 17 months of age, with 5% of boys but only 1% of girls manifesting physically aggressive behaviors on a frequent basis. The results suggest that there is no change in the magnitude of these differences between 17 and 29 months of age.

Age differences in the prevalence of physical aggression among 5-11-year-old Canadian boys and girls.

It has been proven extremely difficult in the past to estimate the prevalence of physical aggression in children for two main reasons: (a) a heterogeneous sampling of behaviors (i.e., mix between physically aggressive and non-physically aggressive antisocial behaviors), and (b) a lack of a "gold standard" to identify children who exhibit physically aggressive behaviors on a frequent basis. The goal of this study was to test for age differences in the prevalence of physical aggression in the Canadian population of school-aged boys and girls, using cross-sectional data from the National Longitudinal Survey of Children and Youth (NLSCY). The first wave of the NLSCY included a representative sample of 12,292 Canadian children aged 5-11 years. We used latent class analysis to identify children whose propensity to exhibit physically aggressive behaviors was much higher than that of other children of the same age and sex in the population. The prevalence of physical aggression was estimated at 3.7% in 5-11-year-old boys and ranged from .5% to 2.3% in 11 and 5-year-old girls, respectively. Hence, the results show a decreasing trend in the prevalence of physical aggression with age for girls, but not for boys. These findings suggest the importance of considering the developmental pathways of physical aggression for boys and girls separately.

The evolution of problem and social competence behaviors during toddlerhood: A prospective population-based cohort survey.

Research in developmental psychopathology has long been preoccupied with rather broad categories of behavior, but we know little about the specific behaviors that comprise these categories. The objective of this study was to: (a) estimate the prevalence of problem and social competence behaviors in the general population of children at 17 months of age, and (b) describe the continuity and discontinuity in the degree to which children exhibit these behaviors between 17 and 29 months of age. The results show that frequent problem behaviors are not typical of children under two years of age. Further, the results suggest that it is possible to distinguish between different types of problem behaviors before two years of age. In addition, the results show that gender differences in some problem behaviors are already present before two years of age, and increase in magnitude during toddlerhood. Finally, the results show that interindividual differences in problem behaviors observed before two years of age are stable. The predictive accuracy of frequent problem behaviors in children at 17 months of age was limited, however, with often a majority of toddlers not behaving this way a year later. Overall, our results suggest that toddlerhood represents a critical period when behavioral and emotional problems of potentially clinical significance emerge. Pediatricians should routinely ask parents to report the frequency of their young children's problem behaviors during child health supervision visits so that children whose frequent problem behaviors persist over time can be identified and possibly referred for treatment.

Synthesis, characterization and biological activity of lanthanum(III) complexes containing 2-methylene-1,10-phenanthroline units bridged by aliphatic diamines.

Two novel lanthanum(III) complexes containing 2-methylene-1,10-phenanthroline units bridged by aliphatic diamines were synthesized and characterized by elemental analysis, IR, NMR, thermal analysis and conductance measurements. They have been assayed for anticancer activity in vitro against HL-60 (human leukocytoma) cells, PC-3MIE8 (human prostate carcinoma) cells, BGC-823 (human stomach carcinoma) cells, MDA-MB-435 (human galactophore carcinoma) cells, Bel-7402 (human liver carcinoma) cells, and Hela (human cervix carcinoma) cells. The results show that the two complexes exhibit good cytotoxic activities against different cell lines in general, especially more effective than cisplatin against Bel-7402, BGC-823 and MDA-MB-435 cell lines. DNA-binding studies indicate that, besides the intercalation, the complexes bind to DNA by the other interaction(s), which might be responsible for the production of more compact DNA, coinciding with more A-like feature of DNA as suggested by CD spectra.

A cross-sectional analysis of acute hepatitis B virus reported to the Vancouver Coastal Health Authority from 2000 to 2003.

BACKGROUND: Acute hepatitis B virus (HBV) transmission remains a significant public health problem despite effective vaccination and prophylaxis strategies. Vancouver, British Columbia, has a large ethnic community from endemic areas, which may further impact on the epidemiology of acute HBV. A cross-sectional study of factors associated with acute HBV cases reported to the Vancouver Coastal Health Authority (Vancouver, British Columbia) from 2000 to 2003 is reported. METHODS: New seropositive cases of hepatitis B surface antigen were reported to the Vancouver Coastal Health Authority Office of Communicable Disease Control. Patients meeting both clinical and laboratory criteria for acute HBV were interviewed by telephone for demographic and risk behaviour information. Risk behaviours within the last six months before disease onset were ranked on efficiency of transmission in a mutually exclusive risk category. RESULTS: There were 78 patients of identified acute HBV in Vancouver from 2000 to 2003. The overall incidence rate was 3.38 per 100,000 person years. Outside of Canada, Asia was the most common place of birth (29.5%). The three most frequently identified risk factors were men who have sex with men (21.9%), heterosexual activity with two or more partners (14.0%) and intravenous drug use (14.0%). Sexual contact with an HBV carrier was identified in 9.4% of patients. CONCLUSIONS: Sexual transmission is a major mode in the spread of HBV in Vancouver. Existing public education, surveillance and vaccination strategies for HBV need to be strengthened to address those engaging in risky behaviours.