The use of a standard design medication room to promote medication safety: organizational implications.

Quality Problem: Medication administration is one of the most potentially dangerous tasks in hospitals. In recent years, the medical establishment has gained insight into the importance of environmental and ergonomic factors on patient safety. Limited data are available on how a standard designed medication room (MR) supports safety medication administration.

Use of colour-coded labels for intravenous high-risk medications and lines to improve patient safety.

Problem: Labelling of high-risk drug infusions and lines is a well-recognised safety strategy to prevent medication errors. Although hospital wards characterised by multiple high-risk drug infusions use different types of labelling, little is known about the contribution of a colour-coded label (CCL) to patient safety.

Setting: A quality improvement programme audit at a tertiary care facility, the Hadassah University Medical Center Ein Kerem, Jerusalem, Israel.

How to evaluate the risk-benefit ratio of the low-dose hormone replacement therapy?

Since the results of the women health initiative study showing an overall negative risk-benefit ratio with 0.625 mg of conjugated estrogens plus 2.5mg of medroxyprogesterone acetate, the use of the lowest effective dose of steroids in hormone replacement therapy (HRT) is recommended.

Efficacy and tolerability of pulsed estrogen therapy: a 12-week double-blind placebo-controlled study in highly symptomatic postmenopausal women.

Objective: To confirm the efficacy and safety of pulsed estrogen therapy, a transient daily hormone exposure, for climacteric symptoms in highly symptomatic postmenopausal women.

Patients And Methods: In this multicenter, double-blind, parallel-group study, early postmenopausal women with at least seven moderate to severe vasomotor symptoms per day were randomized to receive intranasal estradiol, 150 or 300 microg/day, or placebo, for 12 weeks. The primary outcome measure was the mean daily number of moderate to severe vasomotor symptoms, as recorded in patient diaries.

[Why has menopause become a public health problem?].

Menopause is a very important public health problem for many reasons. DEMOGRAPHIC: In 1990 there were 467 million women aged 50 years or more; worldwide, they will number 1200 million in 2030. SOCIOLOGICAL: The expectation of life in the Occident for a 50-year-old woman is a further 33 years, thus at this point, a menopausal women is still in active employment.

Comparison of two estradiol transdermal systems (Oesclim 50 and Estraderm TTS 50). II. Local skin tolerability.

Objectives: The objectives were to compare the local skin tolerability of a matrix-type estradiol transdermal system, Oesclim 50, with that of the reservoir-type system, Estraderm TTS 50.

Methods: Two randomised studies were performed. In the first study, the modified Draize-Shelanski-Jordan method of sensitization was used in an open, parallel-group trial to compare the cutaneous tolerability of repeated applications of Oesclim 50 with that of Estraderm TTS 50 in 24 healthy postmenopausal women.

Comparison of two estradiol transdermal systems (Oesclim 50 and Estraderm TTS 50). I. Tolerability, adhesion and efficacy.

Objectives: The objectives were to compare the tolerability, adhesion and efficacy of a new matrix-type estradiol transdermal system, Oesclim 50, with those of Estraderm TTS 50, a reservoir-type system.

Methods: This was an open, randomised, parallel-group, multi-centre clinical trial, performed in six European countries. A total of 143 healthy menopausal women were allocated to treatment with Oesclim 50 and 140 to Estraderm TTS 50.

Intra-uterine device failure: relation with drug use.

A case-control study was undertaken in order to test the relationship between commonly used anti-inflammatory agents and the efficacy of intra-uterine devices (IUDs). Women who had become pregnant while wearing an IUD were compared with non-pregnant IUD users. 717 cases and 717 controls were recruited from the same medical practices.

[Inhibition of ovarian function using a triphasic combination with gestodene].

The author reports the results of a prospective study of 10 women during six months use of an oral contraceptive combination with gestodene. Inhibition of ovarian function is showed by rapidly decreasing serum levels of estradiol and progesterone. Clinical and metabolic tolerance is excellent.

Immune basis for cimetidine-induced pancytopenia.

We report a case of a female patient with chronic myelogenous leukemia who presented, 8 yr after initial diagnosis, with pancytopenia, encephalopathy, and myalgia. The tentative diagnosis was accelerated phase of chronic myelogenous leukemia. However, because the patient had been treated with cimetidine for 7 months we first omitted this drug.

[Luteal insufficiency and sterility].

Luteal insufficiency is badly defined, and shows up with difficulty as a definite syndrome, and, although regarded by some as a frequent cause of hypofertility, is found by others in 3% of cases only. The author attempts to establish objective criteria for luteal insufficiency and to evaluate the proposed therapy, emphasising that the apparent good results are difficult to authenticate in the absence of a control series.

[The menopause. Therapeutic measures].

Hormonal therapy of the menopause can only be conceived with a careful choice of products and a judicious association of oestrogens and progestagens.