Evaluation of a Pharmacist-Led Penicillin Allergy Assessment Program and Allergy Delabeling in a Tertiary Care Hospital.

Importance: Penicillin allergies are frequently mislabeled, which may contribute to use of less-preferred alternative antibiotics.

Objective: To evaluate a pharmacist-led allergy assessment program's association with antimicrobial use and clinical outcomes.

Design, Setting, And Participants: A pharmacist-led allergy assessment program was launched in 2 phases (June 1, 2015, and November 2, 2016) at a single-center tertiary referral hospital.

Things We Do For No Reason™: Failing to Question a Penicillin Allergy History.

Inspired by the ABIM Foundation's Choosing Wisely campaign, the "Things We Do for No Reason™" (TWDFNR) series reviews practices that have become common parts of hospital care but may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent "black and white" conclusions or clinical practice standards but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion.

The Eyes Have It: Eyelid Swelling and Rash in a 79-year-old Woman With Macular Degeneration.

Introduction: A 79-year-old woman with macular degeneration was referred to the Allergy/Immunology clinic for the evaluation of a potential allergy to anti-vascular endothelial growth factor (anti-VEGF) treatments. The patient developed urticaria and eyelid swelling immediately following a retinal injection of aflibercept, which she had previously tolerated. She previously had allergic reactions following ranibizumab and bevacizumab injections.

Enterovirus D68 and Panton-Valentine Leukocidin-Positive Staphylococcus aureus Respiratory Coinfection with Fatal Outcome.

A previously healthy 10-year-old girl with a 2-day history of upper respiratory illness and fever rapidly developed respiratory failure and sepsis with leukopenia, and expired despite attempts at resuscitation. Postmortem examination revealed bilateral necrotizing pneumonia and evidence of disseminated intravascular coagulation. Nasopharyngeal swabs and lung tissue submitted to the Centers for Disease Control and Prevention (CDC) were positive for Enterovirus D68 (EV-D68).

Assessment of single-item literacy questions, age, and education level in the prediction of low health numeracy.

Objective: Determining a patient's health literacy is important to optimum patient care. Single-item questions exist for screening written health literacy. We sought to assess the predictive potential of three common screening questions, along with patient age and education level, in the prediction of low health numerical literacy (numeracy).

IPSS quality of life question: a possible indicator of depression among patients with lower urinary tract symptoms.

Introduction: Depression and benign prostatic hyperplasia (BPH) are prevalent, especially in older patient populations. Emerging data suggest potential interactions between depression and BPH. We sought to assess whether the questions of the International Prostate Symptom Score (IPSS), specifically the quality of life (QoL) question, predict depression.

Posterior lumbar vein off the retrohepatic inferior vena cava: a novel anatomical variant with surgical implications.

Purpose: Resection of tumors involving the inferior vena cava requires vascular control of posteriorly draining lumbar veins to ensure a bloodless field. Surgical texts and atlases assert that lumbar veins do not insert into the inferior vena cava superior to the renal hilum. However, at our institution we have encountered patients undergoing inferior vena cava tumor thrombectomy who have a posterior lumbar vein cephalad to the renal veins.

Major depression drives severity of American Urological Association Symptom Index.

Objectives: To evaluate the unclear relationship between depression and benign prostatic hyperplasia (BPH) by assessing depression's effect on the American Urological Association Symptom Index (AUA-SI) scores. Depression is a common illness associated with chronic inflammatory disease states. Data have suggested a significant role of inflammation in the progression of BPH.

Nocturia associated with depressive symptoms.

Objectives: To assess the relationship between nocturia and depression, two inflammatory conditions that affect a significant number of men worldwide.

Methods: We asked 547 male patients to self-administer the American Urological Association Symptom Score (AUA-SS) and the Geriatric Depression Scale (GDS), a validated screening tool for depression. Univariate analysis identified significant differences in patient characteristics between depressed and nondepressed patients, and binary logistic regression was used to assess the potential relationship between nocturia and depression while controlling for patient demographics and quality of life.

Poorly numerate patients in an inner city hospital misunderstand the American Urological Association symptom score.

Objectives: To hypothesize that numeracy may also predict patient misunderstanding of the American Urological Association symptom score (AUA-SS). Health literacy consists of document and prose literacy, both considered "traditional" literacy. But, health literacy also comprises quantitative literacy or numeracy.

Assessment of the performance of the American Urological Association symptom score in 2 distinct patient populations.

Purpose: Recent research suggests that low education and illiteracy may drive misunderstanding of the American Urological Association Symptom Score, a key tool in the American Urological Association benign prostatic hyperplasia guidelines. It is unclear whether misunderstanding is confined to patients of low socioeconomic status. Therefore, we reevaluated the prevalence and impact of this misunderstanding in a county vs university hospital population.

Patient misunderstanding of the individual questions of the American Urological Association symptom score.

Purpose: Lower urinary tract symptoms are often assessed using the American Urological Association symptom score. However, some patients may experience difficulty completing the AUA questionnaire. We hypothesized that certain individual questions may generate more misunderstanding than others.