Objective: This article describes a study protocol for the implementation of quality and traceability control in the hazardous medication circuit through an analysis of risks and the development and introduction of a Big Data-based software application aimed at performing a continuous and dynamic audit of the whole system. Method: A standardized graphical modeling tool called Business Process Model Notation will be used to generate a detailed description of each of the stages in the hazardous medication circuit with a view to ensuring full traceability of the system. The information on each stage will be collected in a flowchart, which will be used -together with each event's likelihood of occurrence and severity- as a basis to calculate the criticality index of the different control points established and to determine any control measures that may be required. The flowcharts will also be used to develop the technological support needed to capture all such data as may be relevant to the model. Proper quality control of the process will be ensured by client software agents intended to allow automatic applica tion of efficient data processing tools at the different phases. In addition, Big Data methodologies, in particular machine learning, will be used to develop algorithms based on the repository of generated data to come up with patterns capable of improving the protocols to be applied. Lastly, proper operation of the process will be ensured by means of clinicalpharmaceutical verification and a full technical-documentary review of control and registration systems.
Conclusions: The development of a risk management system based on mobile technology will allow integration of hazardous drugs into a standardized system, ensuring the safety, quality, and traceability of the hazardous medication handling process.
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JAMA Pediatr
January 2025
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Importance: Spontaneous reports have indicated that montelukast increases the risk of neuropsychiatric adverse events, and the US Food and Drug Administration added a boxed warning about these risks in 2020. However, the potential mechanism is not well understood, and the observational evidence is scarce, particularly in children.
Objective: To assess the potential association between the use of montelukast and the risk of neuropsychiatric adverse events in children and adolescents.
Curr Mol Med
January 2025
College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310012, China.
Background: The global challenge of Multidrug-resistant Tuberculosis (MDR-TB) presents a substantial public health concern, requiring extended and complex treatment regimens. Understanding the factors impacting treatment results, particularly sputum culture conversion and Body Mass Index (BMI), is crucial. This retrospective cohort investigation conducted in Punjab, Pakistan, sought to explore the correlation between BMI and sputum culture conversion in individuals diagnosed with MDR-TB.
View Article and Find Full Text PDFTransl Lung Cancer Res
December 2024
Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Background: The combination therapy of the B-Raf proto-oncogene (BRAF) inhibitor dabrafenib and the mitogen-activated protein kinase kinase (MEK) inhibitor Trametinib has shown favorable outcomes in patients initially identified with BRAF mutations. However, there are currently no large-scale study data focusing on the use of a triple therapy regimen of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) plus dabrafenib and trametinib in patients with newly concomitant BRAF mutations after acquiring resistance to EGFR-TKIs. Our study aimed to explore the efficacy and safety of the triple therapy regimen through a multi-center real-world experience.
View Article and Find Full Text PDFHeart rate (HR) has been proved to be associated with major adverse cardiovascular events (MACE) in Acute coronary syndrome patients. However, the threshold value and clinical significance of time in target of resting heart rate (TTR-HR) remain insufficiently elucidated. Our study aimed to evaluate the independent association between TTR-HR and cardiovascular outcomes in the follow-up study of ACS.
View Article and Find Full Text PDFESC Heart Fail
January 2025
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Aims: Sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2i) have demonstrated effectiveness in reducing cardiovascular death and heart failure hospitalization (HFH). However, the efficacy and safety of SGLT2 inhibitors in elderly patients with poor general status, such as very low bodyweight or low nutritional status, who are not included in randomized controlled trials, has not yet been examined. In a real-world setting, the introduction of SGLT2 inhibitors to such elderly patients is a very difficult decision to make.
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