Search

Woo-Youn Kim,1,2 Anna Baek,1 Yoonhee Kim,1 Yewon Suh,1,2 Eunsook Lee,1 Eunkyung Euni Lee,1,2 Ju-Yeun Lee,1,2 Jongchan Lee,3– 5 Hee Sun Park,3– 5 Eun Sun Kim,3– 5 Yejee Lim,3– 5 Nak-Hyun Kim,3– 5 Jung Hun Ohn,3– 5 Sun-wook Kim,3– 5 Jiwon Ryu,3– 5 Hye Won Kim3– 5 1Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, South Korea; 2College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea; 3Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; 4Hospital Medicine Center, Seoul National University Bundang Hospital, Seongnam, South Korea; 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaCorrespondence: Hye Won Kim, Email kimhwhw@gmail.comBackground: Transitional medication safety is crucial, as miscommunication about medication changes can lead to significant risks. Unclear or incomplete documentation during care transitions can result in outdated or incorrect medication lists at discharge, potentially causing medication errors, adverse drug events, and inadequate patient education. These issues are exacerbated by extended hospital stays and multiple care events, making accurate medication recall challenging at discharge.Objective: Thus, we aimed to investigate how real-time documentation of in-hospital medication changes prevents undocumented medication changes at discharge and improves physician-pharmacist communication.Methods: We conducted a retrospective cohort study in a tertiary hospital. Two pharmacists reviewed medical records of patients admitted to the acute medical unit from April to June 2020. In-hospital medication discrepancies were determined by comparing preadmission and hospitalization medication lists and it was verified whether the physician’s intent of medication changes was clarified by documentation. By a documentation rate of medication changes of 100% and < 100%, respectively, fully documented (FD) and partially documented (PD) groups were defined. Any undocumented medication changes at discharge were considered a “documentation error at discharge”. Pharmacists’ survey was conducted to assess the impact of appropriate documentation on the pharmacists.Results: After reviewing 400 medication records, patients were categorized into FD (61.3%) and PD (38.8%) groups. Documentation errors at discharge were significantly higher in the PD than in the FD group. Factors associated with documentation errors at discharge included belonging to the PD group, discharge from a non-hospitalist-managed ward, and having three or more intentional discrepancies. Pharmacists showed favorable attitudes towards physician’s documentation.Conclusion: Appropriate documentation of in-hospital medication changes, facilitated by free-text communication, significantly decreased documentation errors at discharge. This analysis underlines the importance of communication between pharmacists and hospitalists in improving patient safety during transitions of care.Plain language summary: During transitions of care, communication failures among healthcare professionals can lead to medication errors. Therefore, effective sharing of information is essential, especially when intentional changes in prescription orders are made. Documenting medication changes facilitates real-time communication, potentially improving medication reconciliation and reducing discrepancies. However, inadequate documentation of medication changes is common in clinical practice. This retrospective cohort study underlines the importance of real-time documentation of in-hospital medication changes. There was a significant reduction in documentation errors at discharge in fully documented group, where real-time documentation of medication changes was more prevalent. Pharmacists showed favorable attitudes toward the physician’s real-time documenting of medication changes because it provided valuable information on understanding the physician’s intent and improving communication and also saved time for pharmacists. This study concludes that physicians’ documentation on medication changes may reduce documentation errors at discharge, meaning that proper documentation of medication changes could enhance patient safety through effective communication.Keywords: medication reconciliation, medication safety, transitions in care, hospital information systems, hospital discharge, quality audit

This article explores the significance of safeguarding the endothelial glycocalyx (EG) in individuals with COVID-19. The EG is a layer of glycoproteins that lines blood vessels and plays a critical role in maintaining vascular health. Damage to the EG has been associated with severe vascular complications in COVID-19, and interactions between the host and pathogen may contribute to this damage. The article suggests that therapeutic agents such as neutralizing antibodies, low molecular weight heparin, IL-6 receptor blockers, and corticosteroids may help protect the EG and reduce the severity of the disease. The article also discusses potential therapies that could protect and restore the EG in COVID-19 patients, including approved COVID-19 vaccines, tocilizumab, baricitinib, dexamethasone, low molecular weight heparin (LMWH), myeloperoxidase (MPO) inhibitors, and Rho kinase (ROCK) inhibitors. Additionally, therapies like imatinib, fucoidan, rhamnan sulfate (RS), sulodexide, fresh frozen plasma (FFP), albumin, and fingolimod (FTY720) may aid in the restoration of the EG. However, further research is necessary to assess the effectiveness and safety of these treatments. [Extracted from the article]

ABSTRACT INTRODUCTIONAn intrauterine contraceptive device (IUCD) is a common contraception method used for family planning. IUCD erosion into adjacent organs is a rare but serious complication of IUCD use. CASE PRESENTATIONA 41-year-old female presented to us with a leaking left ectopic pregnancy. Emergency laparotomy and left salpingectomy were performed. A copper ICUD was found intraperitoneally and part of it had completely eroded into the sigmoid colon. Sigmoid colotomy was performed and the IUCD was removed successfully. Further history revealed that the patient had her IUCD inserted 12 years previously but was forgotten. The patient was discharged well after 4 days of admission. DISCUSSIONErosion of an IUCD into the colon is uncommon and may be asymptomatic or present with bowel perforation and obstruction. There should be a high index of suspicion for pregnancy occurring among women post-IUCD insertion. A misplaced IUCD can cause chronic inflammation of the fallopian tube, which may alter tubal functionality and increase the risk of ectopic pregnancy. Family planning is commonly done in primary health care. Primary care education and counselling are essential to improve awareness of fertile women to prevent similar complications. Periodic examination of IUCD string either by users or primary health-care practitioners is crucial. Ultrasound can be advocated if there are difficulties with the insertion. An abdominal radiograph is useful and should be performed in the case of missing IUCDs.

Despite the high risk of cancer to the population, Korean Americans are known to have lower knowledge about cancer related information and a lower level of adherence to cancer prevention guidelines. This indicates the necessity of cancer interventions targeting the Korean American population. To reach this population effectively, it is imperative to understand Korean Americans cancer information seeking behaviors. This study (a) identified cancer information sources that are trusted and used by Korean American women and (b) examined how general media exposure and trust in cancer information sources are related to the use of these sources. It also (c) explored perceived usefulness and limitations of cancer information sources. A mixed methods study using seven focus group interviews with 34 Korean American women and surveys with 152 Korean American women was conducted in the Washington, DC, metropolitan area from 2011 to 2012. The results indicate that Korean American women viewed health care professionals as the most trusted cancer information source but used the Internet and Korean ethnic media more often for cancer information seeking because of language, cultural, and economic barriers. Korean American women were most likely to obtain cancer information from media they used frequently for general purposes. Correlations between usage frequency and trust in doctor/health providers and the Internet as cancer information sources were negligible. When seeking cancer information, important factors for Korean American women were accessibility, affordability, and language proficiency, cultural sensitivity, meeting immediate needs, understandability, convenience, and reliability of cancer information sources. Findings from this study support developing interventions using Korean language media, including print, television and the Internet for health promotion and cancer prevention targeting Korean American women.

Reports on degenerative mitral valve disease in dogs in Malaysia are limited. This retrospective cohort study investigated the association between gender, age group, and breed size with respect to the risk of degenerative mitral valve disease. The median survival time of the dogs in stages B2, C, and D and levels of owners' compliance were also estimated. Canine case records at University Veterinary Hospital, University Putra Malaysia from July 2013 to July 2021 were reviewed. Owners were contacted to ascertain their compliance with the treatments and the current status (deceased/alive) of their pet dog. The risk factors were analyzed through a logistic regression model and median survival time was determined through the Kaplan-Meier estimator curve. In this study, 306 out of 753 (40.6%) dogs with heart disease had degenerative mitral valve disease. Following an adjustment to the age group, small breed size was the only significant risk factor (p < .001). Dogs in B2 had the longest median survival time (p < .001), while compliance to treatment was associated with longer median survival time in dogs in Stages C (p = .015) and D (p = .001). The findings of this study may help in motivating owners to pursue long-term treatment and management of dogs with degenerative mitral valve disease. [ABSTRACT FROM AUTHOR]

Since the 1950s, the United States education system has undergone a dramatic demographic shift characterized by a continuing increase in the cultural diversification of the student population. According to the National Center for Education Statistics, in 1999-2000 international students from East Asia (i.e., China, Hong Kong, Japan, Korea, and Taiwan) constituted 35% out of the total of 514,723 international students. In the classroom, instructors often strive to facilitate the incorporation of international students' knowledge and perspectives into instruction to enhance the communicative and educational experiences of all students. Studies reported that there are different factors associated with international students' oral participation in U.S. university classrooms, such as classroom discourse, learning and teaching styles. An aspect that is not extensively researched and that merits attention of scholars is the study of both linguistic and cultural factors in nonnative speakers' oral communication. Thus, the purpose of this study is to examine linguistic and cultural factors that contribute to East Asian students' (EAS) different levels of oral participation in U.S. university classrooms. (Contains 3 tables.)

A novel contact-less, differential feeding technique suitable for integrated active antenna design is demonstrated. This technique utilizes an odd mode signal to generate fringing fields on either side of a microstrip gap under the antenna. This allows electromagnetic energy to be efficiently coupled from the transmission lines to the radiating antenna. In a balanced integrated antenna amplifier configuration, the proposed non-contact feeding method removes the need for any balun or power combining network. Hence in theory, a compact RF front-end design with lower losses can be realized. This feeding method has been successfully applied to the design of simple passive microstrip patch antennas and active integrated antennas (AIA). Simulated and measured results are also included to validate the proposed feeding concept and antenna designs. The performance of the proposed differential feeding technique on a simple microstrip patch antenna has been systematically studied. The study suggests that the proposed proximity method is broadband in nature, allowing antennas operating at different resonant frequencies to be swapped without the need to change the feed dimensions and without degrading the matching performance. Index Terms--Active integrated antenna (AIA), contact-less coupling, differential antenna, microstrip antenna, proximity coupling, push-pull amplifier and differentially fed antenna.

The pattern of birth of early-onset of anorexia nervosa (AN) in an equatorial region were investigated and analyzed by using chi-square analysis method. The results demonstrated no difference in the seasonal pattern in the birth rates of patients with AN across the year compared to general population with restrictive and binge/purge subtypes.