Results: The pharmacists reported a total of 785 DRPs (average of 6.5/patient). DRPs were more common among home-dwelling patients (7.2) than those in the assisted-living setting (5.5; P = 0.014)
but were similar in nature. Inappropriate drug choices were the most common DRPs (17% of DRPs), involving most often hypnotics and sedatives. selleck chemicals Also, indications with no treatment were common (16%), particularly those associated with cardiovascular diseases and osteoporosis. Pharmacists made 649 recommendations, 55% (n = 360) of which were accepted by physicians without revision. In 51% of DRPs (n = 403), CMRs resulted in change of drug therapy; stopping a drug was the most common change.
Conclusion: Specially trained pharmacists were able to identify DRPs among elderly primary care patients by using a CMR procedure, and more than one-half of the identified MAPK Inhibitor Library DRPs led to medication changes. The pharmacists’ special knowledge of geriatric pharmacotherapy and access to clinical patient data were crucial for recognizing DRPs.”
“Introduction: Difficult airway management in children is challenging. One alternative device to the gold standard of direct laryngoscopy is the STORZ Bonfils fiberscope (Karl Storz Endoscopy, Tuttlingen, Germany), a rigid fiberoptic stylette-like scope with a curved tip. Although results in adults have been encouraging, reports
regarding its use in children have been conflicting. We compared the effectiveness of a standard laryngoscope to the Bonfils fiberscope in a simulated difficult infant airway.
Methods: Ten pediatric anesthesiologists were recruited for this study and asked to perform three sets of tasks. For the first task, each Selleck Napabucasin participant intubated an unaltered manikin (SimBaby (TM), Laerdal, Puchheim, Germany) five times using a styletted 3.5 endotracheal tube (ETT) and a Miller 1 blade (group DL-Normal). For the second task, a difficult airway configuration simulating a Cormack-Lehane grade 3B view was created by fixing a Miller-1 blade into position in the manikin using a laboratory
stand. Each participant then intubated the manikin five times with a styletted 3.5 ETT using conventional technique but without touching the laryngoscope (group DL-Difficult). In the third task, the manikin was kept in the same difficult airway configuration, and each participant intubated the manikin five times using a 3.5-mm ETT mounted on the Bonfils fiberscope as an adjunct to direct laryngoscopy with the Miller-1 blade (group BF-Difficult). Primary outcomes were time to intubate and success rate.
Results: A total of 150 intubations were performed. Correct ETT placement was achieved in 100% of attempts in group DL-Normal, 90% of attempts in group DL-Difficult and 98% of attempts in BF-Difficult. Time to intubate averaged 14 s (interquartile range 12-16) in group DL-Normal; 12 s (10-15) in group DL-Difficult; and 11 s (10-18) in group BF-Difficult.