Pharmacist-led intervention to improve medication use in older inpatients using the Drug Burden Index: a study protocol for a before/after intervention with a retrospective control group and multiple case analysis.

Introduction: Polypharmacy and potentially inappropriate medication use is common in older adults and is associated with adverse outcomes such as falls and hospitalisations.

Methods And Analysis: This study is a pharmacist-led medication optimisation initiative using an electronic tool (the Drug Burden Index (DBI) Calculator) in four hospital sites in the Canadian province of Nova Scotia. The study aims to enrol 160 participants between the preintervention and intervention groups.

Inferior vena cava calibre on paediatric trauma CT may be a useful predictor for the development of shock.

Aim: To investigate whether inferior vena cava (IVC) calibre on paediatric trauma computed tomography (CT) can help anticipate outcomes in children.

Materials And Methods: The imaging and clinical records of 52 paediatric trauma admissions to the level 1 major trauma centre at St George's Hospital, London, UK, were retrospectively reviewed. The IVC dimensions, evidence of significant haemorrhage on CT, and the presence of components of the classical hypoperfusion complex, such as bowel and adrenal hyperenhancement, were recorded.

Left ventricular aneurysm in a four-year-old child: a diagnostic challenge.

We describe spontaneous rupture of a congenital left ventricular (LV) aneurysm with subsequent tamponade and cardiac arrest in a 4-year-old male with staphylococcal septicemia. Emergency resuscitation, thoracotomy, and oversewing were successfully undertaken in the pediatric intensive care unit. There was complete cardiovascular recovery without adverse neurodevelopmental sequelae.

Air enema reduction of intussusception: a registrar-led, protocol-driven service is safe and effective.

Purpose: In the UK, air enema reduction of intussusception is predominantly performed by consultant radiologists. At our institution, it is usually performed by a team involving radiology and surgical registrars. The purpose of this study was to assess who performs air enemas in the UK and the efficacy and safety of our registrar-led service.

Perioperative management of the child on long-term opioids.

The strategies used to manage children exposed to long-term opioids are extrapolated from adult literature. Opioid consumption during the perioperative period is more than three times that observed in patients not taking chronic opioids. A sparing use of opioids in the perioperative period results in both poor pain management and withdrawal phenomena.