Medication errors and response bias: the tip of the iceberg.

Background: Medication errors are a common cause of morbidity and mortality.

Objectives: To evaluate the rate of acknowledgment of medication errors as reported by physicians working in the community and in hospitals.

Methods: An anonymous questionnaire was sent to 9320 active physicians (about 48% community physicians, 17% hospital physicians and 35% working in both places), with questions on the rate and type of medication errors that they had encountered during their professional career.

Pregnancy outcome of women exposed to azathioprine during pregnancy.

Background: Azathioprine (AZP) interferes with nucleic acid synthesis and is teratogenic in animals. In view of the paucity of information on the use of AZP during pregnancy we investigated this subject in a prospective, controlled, multicenter study. Our objective was too determine whether exposure to AZP during pregnancy increases the risk for major malformations and to determine the effect on pregnancy outcome.

Repeated supratherapeutic doses of paracetamol in children--a literature review and suggested clinical approach.

Unlabelled: The safety of paracetamol when given in the recommended dosage is well documented. However, in recent years there have been many reports of liver failure associated with repeated exposure to supratherapeutic doses of paracetamol. This paper reviews the literature on chronic supratherapeutic paracetamol exposure in children and the different dosing guidelines.

Metamizol (dipyrone, optalgin) in pregnancy, is it safe? A prospective comparative study.

Aim: To assess the teratogenic effect of metamizol when used during the first trimester of pregnancy.

Methods: One hundred and eight women who used metamizol during the first trimester of pregnancy were recruited from 4 teratogen information centers in Israel (3) and in Italy (1). The study group was paired for age, smoking habits and alcohol consumption with a comparative group exposed to acetaminophen.

First-trimester exposure to amoxycillin/clavulanic acid: a prospective, controlled study.

Aims: The number of published studies on the use of amoxycillin/clavulanic acid during pregnancy is small and so is the number of pregnancies investigated in those studies. In this study we wished to investigate prospectively the safety of intrauterine exposure to amoxycillin/clavulanic acid in a relatively large cohort of women.

Methods: Women treated (n = 191) with amoxycillin/clavulanic acid during the first trimester of pregnancy were recruited from two teratogen information centres in Israel.

[Methemoglobinemia in children as a differential diagnosis of cyanosis].

Methemoglobinemia is characterized by cyanosis with various degrees of severity. Symptoms range from asymptomatic to unconsciousness and death. Although cyanosis caused by methemoglobinemia is well-documented in the literature, it is rare and the consequences can be fatal.

Use of antibiotic and analgesic drugs during lactation.

During lactation, multiple situations can arise that require maternal pharmacological treatment. Because of the many health advantages of human milk to infants, breast feeding should be interrupted only when the needed drug might be harmful to the nursing child and exposure via the breast milk will be sufficient to pose a risk. Since the majority of drugs have not been shown to cause adverse effects when used during lactation, and even temporary interruption of breast feeding can be difficult for the nursing dyad, decisions regarding maternal medication use during breast feeding should be based on accurate and up-to-date information.

Glutathione, glutathione-dependent enzymes and antioxidant status in erythrocytes from children treated with high-dose paracetamol.

Aim: To investigate glutathione and antioxidant status changes in erythrocytes from febrile children receiving repeated supratherapeutic paracetamol doses.

Methods: Fifty-one children aged 2 months to 10 years participated in the study. Three groups were studied: group 1 (n = 24) included afebrile children who did not receive paracetamol; and groups 2 (n = 13) and 3 (n = 14) included children who had fever above 38.

Metoclopramide for nausea and vomiting of pregnancy: a prospective multicenter international study.

Nausea and vomiting are very common during pregnancy, mainly throughout the first trimester. Metoclopramide is a dopamine receptor blocking drug that is commonly used to treat nausea and vomiting. The aim of this prospective study was to investigate the effect on the fetus of intrauterine exposure to metoclopramide.

Unlicensed and off-label medication use in a neonatal intensive care unit: a prospective study.

The aim of this study is to determine the extent of use of medications that have not been specifically licensed for use in children (unlicensed), or medications whose use is not in accordance with the conditions of their license (off-label), in neonates in a neonatal intensive care unit (NICU). Medications given to 105 neonates were prospectively reviewed every 2 weeks during a 4-month period. The assessment as to whether every medication prescribed was unlicensed or off-label for use in children was based on a number of reference sources.

A prospective study of multiple supratherapeutic acetaminophen doses in febrile children.

Repeated doses of acetaminophen given for therapeutic reasons have been reported to cause hepatotoxicity in adults and children. We studied the effect of repeated acetaminophen (APAP) overdoses administered for therapeutic purposes in a prospective cohort of children. Forty-four children, aged 2 mo to 10 y were referred with a fever of >38.

Colonization rate of bacteria in the throat of healthy infants.

Objective: the human throat is a major ecological site for various bacteria that can reach neighbouring sterile sites and cause mild infections or invasive diseases. The aim of this study was to investigate the carriage rate of several potential pathogens in the throat of healthy children under the age of 2 years.

Methods: cultures were taken from the tonsils of 1000 healthy infants aged 1-24 months attending well-baby clinics, who had not received antibiotic therapy during the preceding 14 days.