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Atrial fibrillation (AF) is the most common cardiac arrhythmia and is normally treated by RF ablation. Intracardiac echography (ICE) is widely employed during RF ablation procedures to guide the electrophysiologist in navigating the ablation catheter, although only 2-D probes are currently clinically used. A 3-D ICE catheter would not only improve visualization of the atrium and ablation catheter, but it might also provide the 3-D mapping of the electromechanical wave (EW) propagation pattern, which represents the mechanical response of cardiac tissue to electrical activity. The detection of this EW needs 3-D high-frame-rate imaging, which is generally only realizable in tradeoff with channel count and image quality. In this simulation-based study, we propose a high volume rate imaging scheme for a 3-D ICE probe design that employs 1-D micro-beamforming in the elevation direction. Such a probe can achieve a high frame rate while reducing the channel count sufficiently for realization in a 10-Fr catheter. To suppress the grating-lobe (GL) artifacts associated with micro-beamforming in the elevation direction, a limited number of fan-shaped beams with a wide azimuthal and narrow elevational opening angle are sequentially steered to insonify slices of the region of interest. An angular weighted averaging of reconstructed subvolumes further reduces the GL artifacts. We optimize the transmit beam divergence and central frequency based on the required image quality for EW imaging (EWI). Numerical simulation results show that a set of seven fan-shaped transmission beams can provide a frame rate of 1000 Hz and a sufficient spatial resolution to visualize the EW propagation on a large 3-D surface.

Objectives: Multimorbidity of geriatric patients often leads to polypharmacy that increases the risk for drug interactions. Geriatric patients are also more sensitive to adverse drug reactions due to physiological changes resulting from ageing. Hence, the use of medicines should be considered thoroughly. This systematic literature review aimed at identifying and presenting available evidence on the effect of pharmaceutical interventions on geriatric patients, their medications or healthcare costs in a clinical setting in Europe., Methods: We included all studies on research of pharmaceutical interventions on geriatric inpatients (≥65 years) in Europe since 2001. Database searches were conducted on PubMed, EMBASE, The Cochrane Library and AgeInfo. In addition, the following journals were searched manually: European Journal of Hospital Pharmacy , ' Krankenhauspharmazie ', ' Medizinische Monatsschrift für Pharmazeuten ' and ' Zeitschrift für Gerontologie und Geriatrie '., Results: Database screening yielded 8058 hits. After deletion of duplicates, screening of title and abstract, 143 full-text articles were analysed and 17 papers were included. Manual searching added four more papers. Included studies were conducted in Belgium, Denmark, England, Ireland, the Netherlands, Sweden and Spain. They demonstrate that pharmaceutical care on wards leads to more appropriate medication use and might reduce outcomes like drug-related readmissions. Intensified pharmaceutical care showed additional effects, even in countries with established pharmaceutical care in hospitals., Conclusions: This systematic literature review demonstrates that ward-based pharmacists may improve the appropriateness of medications, seamless care and drug safety for geriatric inpatients while being cost effective., Competing Interests: Competing interests: None declared.

Purpose: Prescribing is an effective and economical means of delivering health care. The aim of this study is to assess the quality of prescriptions in an Acute Medical Assessment Unit (AMAU) at Aberdeen Royal Infirmary (ARI)., Methods: Prescription data were collected from all available medication charts of patients admitted to the ward over a 2-week period. Prescription quality indicators were divided into two categories: prescription chart related (e.g. complete patient information and absence of drug-drug interactions (DDIs)) and medication related (e.g. legibility of handwriting, generic prescribing and adherence to hospital's formulary)., Results: Patient identifiers were omitted in 4% (n = 8) of the medication charts included in assessing prescribing quality. Patient allergies were omitted in 36% (n = 76) of charts. At least one DDI was detected in 26% (n = 55) of the charts. The mean number of medications prescribed per patient was seven (95%CI, 6.53-7.65). The median number of medication-related prescribing errors per medication chart was two (interquartile range (IQR), 1-3). The distribution of these errors was significantly higher in charts with five or more medications (p < 0.001)., Conclusion: This study demonstrates a relatively acceptable level of prescription quality compared to the published literature. However, the number of DDIs and level of allergy documentation are of concern emphasising the need for continued education in this field., (Copyright (c) 2009 John Wiley & Sons, Ltd.)

Aims: To apply established methods to identify ADR-related admissions and to determine the proportion which was preventable and which were caused by non-prescription medicines (NPMs)., Methods: This prospective, observational study screened all acute hospital admissions (n = 1,101) by ward pharmacists over a 2-week period. Suspected ADR-related admissions were reported to the researcher and established criteria were used to evaluate probability, causality and preventability of the ADR-related admissions., Results: Of the 1,101 emergency admissions which occurred during the study period, 30 were categorised as ADR-related, equating to a prevalence of 2.7% (95% CI, 1.8-3.7%). Three (9.7%) of the 30 admissions were associated with NPMs. The ADR was the dominant reason for admission in 56.7% (n = 17/30) and only 13.3% (n = 4/30) of all reported admissions were assessed as unavoidable., Conclusion: The proportion of ADR-related admissions was lower than in previous studies in the UK. A substantial proportion of ADRs was associated with NPMs, highlighting the need for greater awareness amongst patients, prescribers and other health care professionals regarding possible serious adverse effects caused by these medicines.