A patient-safety investigation motivated by a lawsuit over pneumococcal sepsis in a patient who had undergone splenectomy but never received pneumococcal vaccination demonstrates the complexity of ...redesigning systems and care processes to prevent common errors.
It was no one's fault, but it was everyone's fault. The 53-year-old woman had presented with pneumococcal sepsis with disseminated intravascular coagulation and had barely survived but had lost multiple digits. Ten years earlier, she had undergone splenectomy after a motor vehicle accident. There was no evidence that she had received pneumococcal vaccination at any time since the operation. After she recovered, she filed suit against her primary care physician, a doctor in our integrated delivery system. We settled the case and began the work of trying to prevent similar omissions in the future. We discovered that although information technology . . .
Drugs for Atrial Fibrillation
JAMA : the journal of the American Medical Association,
11/2019, Letnik:
322, Številka:
18
Journal Article
Recenzirano
Several treatment options for atrial fibrillation (AF) include anticoagulation, rate control and rhythm control. The basis for the clinical decision to use an oral anticoagulant in patients with ...nonvalvular AF is explained. DC cardioversion is the treatment of choice for urgent conversion of symptomatic unstable AF.
JAMA has decided to publish a theme issue on infectious disease and immunology to help focus the attention of the medical community on novel research and to provide clinicians with new information on ...infectious diseases. Authors have been invited to submit papers and manuscripts on any topics pertaining to the biology, etiology, epidemiology, prevention, diagnosis or treatment of infectious diseases and immunological disorders.
The FDA has approved naloxegol (Movantik-AstraZeneca), a pegylated derivative of the opioid antagonist naloxone, for oral treatment of opioid-induced constipation in adults with chronic noncancer ...pain. It is the only oral opioid antagonist approved for this indication in the US. Here, the standard treatment and adverse effects of naloxegol are detailed.
The FDA has approved Gimoti (Evoke), a nasal spray formulation of the dopamine-2 (D2) receptor antagonist metoclopramide, for relief of symptoms in adults with acute and recurrent diabetic ...gastroparesis. Metoclopramide (Reglan, and generics) has been available for years in conventional and orally-disintegrating tablets and in an injectable formulation. It is the only drug that is FDA-approved for treatment of diabetic gastroparesis.
Pitolisant (Wakix) for Narcolepsy
JAMA : the journal of the American Medical Association,
09/2021, Letnik:
326, Številka:
11
Journal Article
Recenzirano
The FDA has approved pitolisant (Wakix - Harmony), a histamine-3 (H3)-receptor antagonist/inverse agonist, for treatment of excessive daytime sleepiness (EDS) or cataplexy in adults with narcolepsy. ...It is the first H3-receptor antagonist/inverse agonist to become available in the US and the first non-controlled substance to receive FDA approval for these indications. Pitolisant has been available in Europe since 2016. The CNS stimulant modafinil (Provigil, and generics) and its R-enantiomer armodafinil (Nuvigil, and generics) have been used for years for first-line treatment of EDS due to narcolepsy. Alternative treatments include sympathomimetic stimulants such as mixed amphetamine salts (Adderall, and generics) and methylphenidate (Ritalin, and others). Solriamfetol (Sunosi), a dopamine and norepinephrine reuptake inhibitor, was approved by the FDA in 2019 for treatment of EDS due to narcolepsy or obstructive sleep apnea; it has not been compared to first-line treatments. A sodium oxybate oral solution (Xyrem) and a mixed-salt oxybate oral solution (Xywav) are FDA-approved for treatment of EDS due to narcolepsy, but they can cause serious CNS adverse effects, including respiratory depression.
Drugs for Atopic Dermatitis
JAMA : the journal of the American Medical Association,
04/2021, Letnik:
325, Številka:
13
Journal Article
Recenzirano
This Medical Letter provides a Table summarizing key information about topical corticosteroids available for atopic dermatitis published as part of a comprehensive review on the topic.
Dupilumab (Dupixent) for Asthma
JAMA : the journal of the American Medical Association,
03/2019, Letnik:
321, Številka:
10
Journal Article
Recenzirano
This Medical Letter review summarizes doses and formulations of dupilumab (Dupixent), a subcutaneously injected monoclonal antibody add-on maintenance treatment approved for patients aged 12 years or ...older with moderate to severe asthma with an eosinophilic phenotype or with oral corticosteroid-dependent asthma.
