ABSTRACT
Propranolol is used as the first-line treatment for infantile hemangiomas (IHs). As oral formulations can cause systemic adverse drug reactions (ADRs), we prepared topical propranolol formulations and evaluated their pharmaceutical profiles. We also present three cases of pediatric patients with IHs who were treated with the propranolol formulations. Propranolol cream (hydrophilic cream, 1, 3, and 5%) and gels (carboxyvinyl polymer, hydroxypropyl methylcellulose, gellan gum, 1%) were prepared. The in vitro skin permeability of these formulations was assessed using Franz-type diffusion cells. The pharmaceutical profiles, including propranolol content, pH, and ductility, of the propranolol creams were evaluated. For the stability test, similar pharmaceutical evaluations were performed after the creams were stored at 25 °C and 56% relative humidity for 3 months. We examined three patients treated with propranolol cream to investigate the clinical course of IH and adverse events after the propranolol cream was applied for 5-12 months. In the in vitro skin permeability assay, topical propranolol formulations made of hydrophilic cream and gellan gum permeated the most. The amount of propranolol that permeated increased with propranolol concentration. After storage for 3 months, no substantial changes were observed in any pharmaceutical profile. The IHs were discolored in all patients. Tumor size also decreased in some patients. Furthermore, no adverse events caused by propranolol cream were observed during application. In conclusion, propranolol cream can be prepared as a hospital formulation with adequate quality. Topical propranolol therapy is effective in reducing the incidence of systemic ADRs.
Subject(s)
Hemangioma , Skin Neoplasms , Child , Hemangioma/chemically induced , Hemangioma/drug therapy , Hemangioma/pathology , Humans , Hypromellose Derivatives , Infant , Propranolol/adverse effects , Propranolol/therapeutic use , Skin , Skin Neoplasms/drug therapyABSTRACT
BACKGROUND: Comprehensive cancer genomic profiling has been used recently for patients with advanced solid cancers. Two cancer genomic profiling tests for patients with no standard treatment are covered by Japanese public health insurance since June 2019. METHODS: We prospectively analyzed data of 189 patients with solid cancers who underwent either of the two-cancer genomic profiling tests at Hokkaido University Hospital and its liaison hospitals and whose results were discussed in molecular tumor board at Hokkaido University Hospital between August 2019 and July 2020. RESULTS: All 189 patients had appropriate results. Actionable gene alterations were identified in 93 patients (49%). Frequent mutations included PIK3CA (12%) mutation, BRCA1/2 alteration (7%), ERBB2 amplification (6%) and tumor mutation burden-High (4%). The median turnaround time from sample shipping to acquisition by the expert panel was 26 days. Although 115 patients (61%) were provided with information for genotype-matched therapies, only 21 (11%) received them. Notably, four of eight patients below the age of 20 years were provided information for genotype-matched therapies, and three received them. Their response rates and disease control rates were 29% and 67%, respectively. Most patients who did not undergo the genotype-matched therapies were provided information for only investigational drugs in phases I and II at distant clinical trial sites in central Japan. Twenty-six patients were informed of suspected germline findings, while 11 patients (42%) received genetic counseling. CONCLUSIONS: The publicly reimbursed cancer genomic profilings may lead to the modest but favorable therapeutic efficacy of genotype-matched therapy for solid cancer patients with no standard therapy. However, poor access to genotype-matched therapy needs to be resolved.
Subject(s)
Genomics/methods , High-Throughput Nucleotide Sequencing/methods , Insurance/standards , Neoplasms/economics , Neoplasms/genetics , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Japan , Male , Middle Aged , Prospective Studies , Young AdultABSTRACT
BACKGROUND: An increasing number of people are visiting hospital websites to seek better services and treatments compared to the past. It is therefore important for hospitals to develop websites to meet the needs of their patients. However, few studies have investigated whether and how the current hospital websites meet the patient's needs. Above all, in radiation departments, it may be difficult for patients to obtain the desired information regarding modality and diagnosis because such information is subdivided when described on a website. OBJECTIVE: The purpose of this study is to suggest a hospital website search behavior model by analyzing the browsing behavior model using a Bayesian network from the perspective of one-to-one marketing. METHODS: First, we followed the website access log of Hokkaido University Hospital, which was collected from September 1, 2016, to August 31, 2017, and analyzed the access log using Google Analytics. Second, we specified the access records related to radiology from visitor browsing pages and keywords. Third, using these resources, we structured 3 Bayesian network models based on specific patient needs: radiotherapy, nuclear medicine examination, and radiological diagnosis. Analyzing each model, this study considered why some visitors could not reach their desired page and improvements to meet the needs of visitors seeking radiology-related information. RESULTS: The radiotherapy model showed that 74% (67/90) of the target visitors could reach their requested page, but only 2% (2/90) could reach the Center page where inspection information, one of their requested pages, is posted. By analyzing the behavior of the visitors, we clarified that connecting with the radiotherapy and radiological diagnosis pages is useful for increasing the proportion of patients reaching their requested page. CONCLUSIONS: We proposed solutions for patient web-browsing accessibility based on a Bayesian network. Further analysis is necessary to verify the accuracy of the proposed model in comparison to other models. It is expected that information provided on hospital websites will be improved using this method.
Subject(s)
Radiology/education , User-Centered Design , Bayes Theorem , Hospitals , Humans , Internet , Research Design , Surveys and QuestionnairesABSTRACT
We report the case of an 11-year-old boy who was diagnosed with catecholaminergic polymorphic ventricular tachycardia (CPVT). The patient had a medical history of three episodes of syncope. The last episode was cardiac arrest while swimming. After resuscitation using automated external defibrillator, he was placed under cerebral hypothermia, examined for long QT syndrome, and underwent insertion of implantable cardioverter defibrillator. He was subsequently discharged from hospital without any adverse sequelae. The patient was diagnosed with CPVT after detection of ryanodine receptor 2 mutation. His father also carried the same mutation, although he did not have any symptoms nor did he have a history of syncope. We propose that CPVT should be included in the differential diagnosis in children with recurrent episodes of syncope.
ABSTRACT
An 11-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis (CRMO) and presented with right sacro-femoral and occipital lesions. Initially, a tumor was suspected. However, the bone biopsy showed osteomyelitis with a negative bacterial culture. Bone scintigraphy revealed inflammatory changes on multiple bone lesions. The slight elevation in inflammatory markers such as C-reactive protein was of little clinical value. He was diagnosed with CRMO by sacral biopsy, and the clinical course progressed, with the presence of a new occipital lesion observed after the 1-year follow-up. The administration of non-steroidal anti-inflammatory drugs successfully improved his clinical symptoms. The presence of a skull lesion in the occipital bone of a pediatric patient with CRMO has not been previously reported.
ABSTRACT
BACKGROUND: Although evidence has suggested that computerized drug-drug interaction alert systems may reduce the occurrence of drug-drug interactions, the numerous reminders and alerts generated by such systems could represent an excessive burden for clinicians, resulting in a high override rate of not only unimportant, but also important alerts. METHODS: We analyzed physicians' responses to alerts of relative contraindications and contraindications for coadministration in a computerized drug-drug interaction alert system at Hokkaido University Hospital. In this system, the physician must enter a password to override an alert and continue an order. All of the drug-drug interaction alerts generated between December 2011 and November 2012 at Hokkaido University Hospital were included in this study. RESULTS: The system generated a total of 170 alerts of relative contraindications and contraindication for coadministration; 59 (34.7 %) of the corresponding orders were cancelled after the alert was accepted, and 111 (65.3 %) were overridden. The most frequent contraindication alert was for the combination of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors and fibrates. No incidents involving drug-drug interactions were reported among patients who were prescribed contraindicated drug pairs after an override. CONCLUSIONS: Although computerized drug-drug interaction alert systems that require password overrides appear useful for promoting medication safety, having to enter passwords to override alerts may represent an excessive burden for the prescribing physician. Therefore, both patient safety and physicians' workloads should be taken into consideration in future designs of computerized drug-drug interaction alert systems.
Subject(s)
Drug Interactions , Medical Order Entry Systems/standards , Physicians , Adult , HumansABSTRACT
We describe three cases of hereditary spherocytosis (HS) diagnosed using the eosin-5'-maleimide (EMA) binding test and discuss the relevance of the EMA binding test. In Japan, this test is not widely used because the prevalence of HS is low. This test is a valuable screening test for the diagnosis of HS.
Subject(s)
Eosine Yellowish-(YS)/analogs & derivatives , Spherocytosis, Hereditary/diagnosis , Adult , Child , Female , Humans , Infant , Infant, Newborn , MaleABSTRACT
We report the case of a 6-month-old boy with transient renal dysfunction who had an intensified signal in the splenium of the corpus callosum on magnetic resonance imaging. He presented to hospital with fever and sudden disturbance of consciousness. Cerebrospinal fluid analysis did not show pleocytosis. The mild consciousness disturbance disappeared after 30 min, but the splenial signal persisted even after 8 days. Further, renal glucosuria, increased excretion of select amino acids, and abnormal fractional excretion of electrolytes were observed, indicating renal tubular dysfunction. The abnormal urinary findings spontaneously resolved by day 9 of hospitalization. The splenial lesion took 21 days to normalize. There were no signs of neurological complications 2 months later. This case suggests the possibility of renal involvement in splenial lesions.
Subject(s)
Brain Diseases/complications , Corpus Callosum , Kidney Diseases/complications , Humans , Infant , Male , Remission, SpontaneousABSTRACT
Aims: We evaluated a self-care intervention with a novel mobile application (app) in chronic heart failure (HF) patients. To facilitate patient-centred care in HF management, we developed a self-care support mobile app to boost HF patients' optimal self-care. Methods and results: We conducted a multicentre, randomized, controlled study evaluating the feasibility of the self-care support mobile app designed for use by HF patients. The app consists of a self-monitoring assistant, education, and automated alerts of possible worsening HF. The intervention group received a tablet personal computer (PC) with the self-care support app installed, and the control group received a HF diary. All patients performed self-monitoring at home for 2 months. Their self-care behaviours were evaluated by the European Heart Failure Self-Care Behaviour Scale. We enrolled 24 outpatients with chronic HF (ages 31-78 years; 6 women, 18 men) who had a history of HF hospitalization. During the 2 month study period, the intervention group (n = 13) showed excellent adherence to the self-monitoring of each vital sign, with a median [interquartile range (IQR)] ratio of self-monitoring adherence for blood pressure, body weight, and body temperature at 100% (92-100%) and for oxygen saturation at 100% (91-100%). At 2 months, the intervention group's self-care behaviour score was significantly improved compared with the control group (n = 11) [median (IQR): 16 (16-22) vs. 28 (20-36), P = 0.02], but the HF Knowledge Scale, the General Self-Efficacy Scale, and the Short Form-8 Health Survey scores did not differ between the groups. Conclusion: The novel mobile app for HF is feasible.
ABSTRACT
In order to compare the long-term clinical and angiographic outcomes after sirolimus-eluting stent (SES) and bare-metal stent (BMS) placement in severely calcified lesions using a rotablator under the widespread indication of SES, a nonrandomized examination of 312 consecutive lesions after successful implantation of a BMS (99 lesions in 84 patients; from January 2003) or SES (213 in 167; from September 2004) using a rotablator was conducted. The lesion-based primary endpoints (cardiac death and nonfatal recurrent myocardial infarction) and the secondary endpoint [binary restenosis (BR) (diameter stenosis > 50%) at follow-up angiography] were retrospectively determined in August 2010. The incidence of primary endpoint in the SES group (2.3%; mean follow-up period of 1289 ± 526 days) was significantly lower than that in the BMS group (7.1%; P = 0.043; 1803 ± 887 days), although the several variables related to the endpoints were present in the SES group. Cox proportional hazard model analysis revealed that SES was not significantly related to a primary endpoint [hazard ratio of 0.42 (95% CI, 0.073-2.42; P = 0.33)]. The incidence of BR in the SES group (21.3%) was not significantly different from that in the BMS group (27.1%) (P = 0.33). Multivariate logistic regression analysis revealed that SES was not a significant predictor of BR [Odds ratio of 0.78 (95% CI, 0.41-1.51; P = 0.47)]. Thus, although the results of the present retrospective nonrandomized study demonstrate the long-term safety of SES for calcified lesions using a rotablator in daily practice, SES did not show a benefit for the angiographic outcomes compared to BMS.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/therapy , Coronary Restenosis , Drug-Eluting Stents , Aged , Aged, 80 and over , Coronary Angiography , Female , Humans , Immunosuppressive Agents/administration & dosage , Male , Retrospective Studies , Severity of Illness Index , Sirolimus/administration & dosage , Treatment OutcomeABSTRACT
We report three cases of patients in their eighties who received anti-EGFR antibody mono-therapy as first-line treatment for metastatic colorectal cancer. CASE 1: An 86-year-old woman who received cetuximab after a colostomy for unresectable rectal cancer with synchronous liver and lung metastases. Serum levels of CEA and CA19-9 showed a significant decrease at 2 months, after which they showed a gradual increase. Computed tomography (CT) revealed a reduction in the rectal tumor. CASE 2: An 82-year-old woman who received cetuximab for peritoneal metastases after a transverse colectomy. Serum levels of CEA and CA19-9 decreased to normal levels at 2 months, and CT imaging revealed disappearance of the tumor in the peritoneal cavity. CASE 3: A 79-year-old man who received panitumumab for lung, liver and para-aortic lymph node metastases after a descending colectomy. Serum levels of CEA and CA19-9 showed a decrease at 1 month, after which they showed a gradual increase. No marked change in the tumor was observed by CT. No change was observed in performance status or Vulnerable Elders Survey( VES-13) score, and the effect on overall condition was minimal. Grade 1-2 acneiform skin rash, paronychia, and desquamation, and grade 2-3 dry skin and pruritis were observed. More precise instructions on measures for dealing with skin rash are necessary to obtain higher drug compliance.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents/therapeutic use , Colorectal Neoplasms/drug therapy , ErbB Receptors/antagonists & inhibitors , Aged , Aged, 80 and over , Antibodies, Monoclonal, Humanized , Cetuximab , Colorectal Neoplasms/immunology , ErbB Receptors/immunology , Female , Humans , Male , Neoplasm Metastasis/drug therapy , RecurrenceABSTRACT
A 64-year-old male consulted our clinic due to pancytopenia. Bone marrow appearance was consistent with multiple myeloma and an IgG-κ type M component was detected on electroimmuno-diffusion of urine. MP therapy (melphalan 2 mg/ day, prednisolone 10 mg/day) was started on an outpatient basis, but the pancytopenia worsened. The patient was then admitted to our hospital, and a course of Velcade therapy (bortezomib 2. 4 mg day 1, 4, 8, 11) was started. After a course of Velcade therapy, side effects such as gastrointestinal dysfunction appeared. A month after the disruption of the chomotherapy, the patient suddenly died. The autopsy report stated that the atrial blood showed 19, 200/µL of white blood cells and 39% of plasma cells, and a slight infiltration was found in liver, kidney and vessels. Two days before death, the blood picture showed no plasma cells. The cause of death was considered to be aggressive multiple myeloma.
Subject(s)
Multiple Myeloma/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Autopsy , Biopsy , Boronic Acids/therapeutic use , Bortezomib , Drug Resistance, Neoplasm/drug effects , Fatal Outcome , Humans , Male , Melphalan/administration & dosage , Melphalan/therapeutic use , Middle Aged , Multiple Myeloma/drug therapy , Neoplasm Invasiveness , Prednisolone/administration & dosage , Prednisolone/therapeutic use , Pyrazines/therapeutic useABSTRACT
Cetuximab (Erbitux) is a targeted therapy that used to treat metastatic colorectal cancer. It is classified as a "monoclonal antibody" and "signal transduction inhibitor" by binding to epidermal growth factor receptors (EGFR). We report 6 patients who responded well to cetuximab out of 8 patients with recurrent/advanced colorectal cancer who have received the drug at our hospital since November 2008. Four patients were men and 2 were women, with their ages ranging from 48 to 77 years. The primary cancers were located in the rectum (n=1), sigmoid colon (n=4), and ascending colon (n=1). Performance status (PS) was 0-1. These patients were treated with cetuximab as second-line (n=1), third-line (n=3), fifth-line (n=1), or seventh-line (n=1) therapy. Three patients received cetuximab monotherapy, while the other 3 were given CPT-11 (150 mg/m2, every 2 weeks) as concomitant therapy. Among the 3 patients receiving combination therapy, 2 patients had already received treatment with FOLFIRI. Even in the cetuximab monotherapy group, a partial response (PR) was observed in 2 patients, demonstrating a strong cytoreductive effect. Tumor markers also showed large decreases, with the percent decrease at 1 month being 31.7% and 60.8% in the monotherapy and combination therapy groups, respectively, while it was respectively 14.1% and 29.5% at 2 months. The mean progression-free survival (PFS) time and the time to treatment failure (TTF) were respectively 3.0 months and 4.5 months in the monotherapy group versus 7.3 months and 9.3 months in the combination therapy group. Acneiform rash and paronychia occurred in all 6 patients.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents/therapeutic use , Colorectal Neoplasms/drug therapy , Aged , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Camptothecin/administration & dosage , Camptothecin/analogs & derivatives , Camptothecin/therapeutic use , Cetuximab , Female , Fluorouracil/therapeutic use , Humans , Irinotecan , Leucovorin/therapeutic use , Male , Middle Aged , Rectal Neoplasms/drug therapy , Sigmoid Neoplasms/drug therapyABSTRACT
OBJECTIVES: The antithyroid drug thiamazole has long been known to cause the serious adverse effect of agranulocytosis, and performing regular blood tests is listed among the warnings on the package insert. We conducted a retrospective survey of how often doctors conducted blood tests in accordance with the package insert when thiamazole was prescribed at our hospital. METHODS: The subjects were patients to whom thiamazole was newly prescribed at our hospital between April 2004 and March 2012. During the target period, thiamazole was newly prescribed to 438 patients. RESULTS: We found that blood tests after prescription of thiamazole as listed in the warning section on the package insert are not performed sufficiently. The rate at which white blood cell counts were obtained decreased over time. The rate at which differential leukocyte counts were obtained was approximately 80% of white blood cell counts at all observational time points. In contrast, the percentage of subjects whose white blood cell counts were measured increased according to a time-trend analysis. CONCLUSIONS: This study revealed that blood tests after prescription of thiamazole as listed in the warning section on the package insert are not performed sufficiently at our hospital. The rate at which differential leukocyte counts were obtained was approximately 80% of white blood cell counts at all observational periods. Physician education should be more rigorously performed than presently done, and automatic generation of warnings that urge blood tests and patient education regarding the importance of blood tests is also important.
Subject(s)
Antithyroid Agents/adverse effects , Antithyroid Agents/pharmacology , Hematologic Tests/methods , Methimazole/adverse effects , Methimazole/pharmacology , Product Labeling/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
BACKGROUND: With increasing computerization of nursing records in Japan, standardization of nursing terminology is becoming imperative. Although some efforts have been made to formalize description of nursing practice in Japan with the International Classification of Nursing Practice (ICNP), lack of effective description tools has impacted negatively on the initiatives. PURPOSE: To develop and evaluate an ontological approach that could be used to facilitate the description of nursing practice in Japan with the ICNP. METHODOLOGY: An ontology-based support system was developed using Protégé-2000, mainly by the following three steps: (1) representing a standard classification of nursing practice (the Nursing Master) in Japan; (2) representing a Japanese version of the ICNP; (3) designing an ontology-based framework. A heuristic matching algorithm was developed to automatically match the action labels in the Nursing Master with the terms of the eight axes of the ICNP Nursing Actions Classification. A preliminary evaluation was performed to examine the usefulness of the system. RESULTS: High hit rate was shown on the ICNP axes ActionType, Target, and Location. The evaluation indicated that 51.7+/-5.8% (mean+/-S.D.) of the action labels with only one action type were properly matched, and that in 80+/-4% (mean+/-S.D.) of action labels with more than one action type, at least one valid action type was matched correctly. CONCLUSION: The ontology-based approach using a frame-based knowledge representation system (e.g., Protégé-2000) is useful for supporting the formal description of nursing practice in Japan with the ICNP.
Subject(s)
Nursing Care/classification , Nursing Informatics/methods , Nursing Informatics/standards , Software , Terminology as Topic , Vocabulary, Controlled , Japan , Nursing Care/standards , Software DesignABSTRACT
Despite recent studies examining the association between neurodegenerative diseases and mitochondrial dysfunction, there are not sufficient data on factors that influence cerebrospinal fluid (CSF) lactate levels. Thus, we investigated factors that affect CSF lactate levels in neurodegenerative diseases. We extracted laboratory findings, including CSF lactate, glucose, and protein levels, and demographic and background information, including age and gender, from the electronic medical records of patients with neurodegenerative diseases in order to explore factors that have an impact CSF lactate levels. These patients had been admitted to our department and underwent a CSF examination between April 2007 and March 2015. Data from 83 patients (average age 64.5years; 45 males and 38 females) were analyzed. The patients' diagnoses included amyotrophic lateral sclerosis, multiple system atrophy, spinocerebellar degeneration, corticobasal syndrome, Parkinson's disease, and Huntington's disease. CSF lactate levels were higher in patients with a neurodegenerative disease who were aged 65years and older relative to those who were aged under 65years (p<0.05), and CSF lactate and glucose levels showed a moderate positive correlation (r=0.487). Age and CSF glucose levels influenced CSF lactate levels even after adjusting for gender, age, CSF protein levels, and CSF glucose levels. When investigating CSF lactate levels in neurodegenerative diseases, it is necessary to consider patients' age and CSF glucose levels.
Subject(s)
Aging/cerebrospinal fluid , Glucose/cerebrospinal fluid , Lactic Acid/cerebrospinal fluid , Neurodegenerative Diseases/cerebrospinal fluid , Adult , Aged , Aged, 80 and over , Cerebrospinal Fluid Proteins , Female , Humans , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
In order to establish whether there are differences in DNA-binding proteins between zona fasciculata (ZF) and zona reticularis (ZR) cells of the human adrenal cortex, we prepared nuclear extracts from separated ZF and ZR cells. The formation of DNA-protein complexes was studied using an element in the first intron of the type I and type II 3beta-hydroxysteroid dehydrogenase genes (HSD3B1 and HSD3B2). Using the element in the HSD3B2 gene as a probe, a complex (C1) was formed with extracts from ZF cells but was formed only at a low level with ZR cell extracts. Another pair of complexes (C2/C3) was formed with both ZF and ZR cell extracts. The ZF-specific protein forming C1 was enriched by column chromatography on DEAE-Sepharose and carboxymethyl-Sepharose. Oligonucleotide competition analysis on the enriched fraction gave results consistent with those obtained on the unfractionated material. A further enrichment was brought about by passing the protein over an oligonucleotide affinity column based on the HSD3B2 element. The protein bound to the column was identified as alpha-enolase by mass spectrometry. Although alpha-enolase is a glycolytic enzyme, it binds to specific DNA sequences and has been found to be present in nuclei of various cell types. We performed immunohistochemistry on sections of adult human adrenal cortex and found alpha-enolase to be located in nuclei of ZF cells but to be predominantly cytoplasmic in ZR cells. Transfection of an alpha-enolase expression vector into NCI-H295R human adrenocortical cells increased HSD3B2 promoter activity, suggesting a possible functional role for this protein in regulation of HSD3B2 expression.
Subject(s)
Cell Nucleus/enzymology , DNA-Binding Proteins/analysis , Phosphopyruvate Hydratase/analysis , Tumor Suppressor Proteins/analysis , Zona Fasciculata/enzymology , 3-Hydroxysteroid Dehydrogenases/metabolism , Analysis of Variance , Animals , Biomarkers, Tumor , Cattle , Cell Line , Chromatography, Affinity , DNA-Binding Proteins/genetics , DNA-Binding Proteins/metabolism , Electrophoretic Mobility Shift Assay , Genes, Reporter , Humans , Immunohistochemistry/methods , Isoenzymes/metabolism , Phosphopyruvate Hydratase/genetics , Phosphopyruvate Hydratase/metabolism , Protein Binding , RNA, Messenger/analysis , Transcription, Genetic , Tumor Suppressor Proteins/genetics , Tumor Suppressor Proteins/metabolism , Zona Reticularis/enzymologyABSTRACT
BACKGROUND: Bar-code technology, used for verification of patients and their medication, could prevent medication errors in clinical practice. OBJECTIVE: Retrospective analysis of electronically stored medical error reports was conducted in a university hospital. METHODS: The number of reported medication errors of injected drugs, including wrong drug administration and administration to the wrong patient, was compared before and after implementation of the bar-code verification system for inpatient care. RESULTS: A total of 2867 error reports associated with injection drugs were extracted. Wrong patient errors decreased significantly after implementation of the bar-code verification system (17.4/year vs. 4.5/year, p< 0.05), although wrong drug errors did not decrease sufficiently (24.2/year vs. 20.3/year). The source of medication errors due to wrong drugs was drug preparation in hospital wards. CONCLUSION: Bar-code medication administration is effective for prevention of wrong patient errors. However, ordinary bar-code verification systems are limited in their ability to prevent incorrect drug preparation in hospital wards.