Medication error Dotaz Zobrazit nápovědu
PURPOSE: The aim of this study was to develop a simple, robust, and easy-to-use calibration procedure for correcting misalignments in rosette MRI k-space sampling, with the objective of producing images with minimal artifacts. METHODS: Quick automatic calibration scans were proposed for the beginning of the measurement to collect information on the time course of the rosette acquisition trajectory. A two-parameter model was devised to match the measured time-varying readout gradient delays and approximate the actual rosette sampling trajectory. The proposed calibration approach was implemented, and performance assessment was conducted on both phantoms and human subjects. RESULTS: The fidelity of phantom and in vivo images exhibited significant improvement compared with uncorrected rosette data. The two-parameter calibration approach also demonstrated enhanced precision and reliability, as evidenced by quantitative T2*$$ {\mathrm{T}}_2^{\ast } $$ relaxometry analyses. CONCLUSION: Adequate correction of data sampling is a crucial step in rosette MRI. The presented experimental results underscore the robustness, ease of implementation, and suitability for routine experimental use of the proposed two-parameter rosette trajectory calibration approach.
- MeSH
- algoritmy * MeSH
- artefakty * MeSH
- fantomy radiodiagnostické * MeSH
- kalibrace MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mozek diagnostické zobrazování MeSH
- počítačové zpracování obrazu * metody MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Dual velocity encoding PC-MRI can produce spurious artifacts when using high ratios of velocity encoding values (VENCs), limiting its ability to generate high-quality images across a wide range of encoding velocities. This study aims to propose and compare dual-VENC correction methods for such artifacts. THEORY AND METHODS: Two denoising approaches based on spatiotemporal regularization are proposed and compared with a state-of-the-art method based on sign correction. Accuracy is assessed using simulated data from an aorta and brain aneurysm, as well as 8 two-dimensional (2D) PC-MRI ascending aorta datasets. Two temporal resolutions (30,60) ms and noise levels (9,12) dB are considered, with noise added to the complex magnetization. The error is evaluated with respect to the noise-free measurement in the synthetic case and to the unwrapped image without additional noise in the volunteer datasets. RESULTS: In all studied cases, the proposed methods are more accurate than the Sign Correction technique. Using simulated 2D+T data from the aorta (60 ms, 9 dB), the Dual-VENC (DV) error 0.82±0.07$$ 0.82\pm 0.07 $$ is reduced to: 0.66±0.04$$ 0.66\pm 0.04 $$ (Sign Correction); 0.34±0.04$$ 0.34\pm 0.04 $$ and 0.32±0.04$$ 0.32\pm 0.04 $$ (proposed techniques). The methods are found to be significantly different (p-value <0.05$$ <0.05 $$ ). Importantly, brain aneurysm data revealed that the Sign Correction method is not suitable, as it increases error when the flow is not unidirectional. All three methods improve the accuracy of in vivo data. CONCLUSION: The newly proposed methods outperform the Sign Correction method in improving dual-VENC PC-MRI images. Among them, the approach based on temporal differences has shown the highest accuracy.
- MeSH
- algoritmy * MeSH
- aorta * diagnostické zobrazování MeSH
- artefakty * MeSH
- fantomy radiodiagnostické MeSH
- interpretace obrazu počítačem metody MeSH
- intrakraniální aneurysma diagnostické zobrazování MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mozek diagnostické zobrazování MeSH
- počítačová simulace MeSH
- počítačové zpracování obrazu * metody MeSH
- poměr signál - šum * MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- amblyopie * diagnóza klasifikace terapie MeSH
- anizometropie * terapie MeSH
- časná diagnóza MeSH
- dítě MeSH
- klinické rozhodování MeSH
- lidé MeSH
- okluze terapeutická metody MeSH
- předškolní dítě MeSH
- refrakční vady terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Článek popisuje případ neúmyslného intravenózního podání prokain-penicilinu (P-PNC) místo ordinovaného krystalického penicilinu (G-PNC), přičemž tento výjimečný incident je analyzován z pohledu lidského faktoru a řízení kvality pomocí metody kořenové analýzy (Root Cause Analysis, RCA). Případ zdůrazňuje zásadní roli infuzního setu s filtrem, který zamezil průchodu větších částic suspenze do krevního oběhu pacienta a tím předešel vážnějším následkům. Incident je současně významným příkladem pro ošetřovatelskou praxi, který podtrhuje důležitost důsledného dodržování bezpečnostních a standardních operačních postupů (SOP) v rámci kompetencí sester a nutnost zapojení klinického farmaceuta při práci s LASA léčivy.
The article describes a case of unintended intravenous administration of procaine penicillin (P-PNC) instead of the prescribed crystalline penicillin (G-PNC). This unique incident is analyzed from the perspectives of human factors and quality management, using the Root Cause Analysis (RCA) method. A key element was the protective role of the infusion set with a filter, which prevented larger suspension particles from entering the patient's bloodstream, thereby averting more serious consequences. This case also serves as an important example for nursing practice, emphasizing the necessity of adhering to safety and Standard Operating Procedures (SOP) within the scope of nursing competencies, as well as the crucial role of clinical pharmacists in managing LASA (Look-Alike, Sound-Alike) medications.
- Klíčová slova
- kořenová analýza, Hoigné syndrom,
- MeSH
- intravenózní podání MeSH
- lidé MeSH
- medikační omyly * MeSH
- odborná způsobilost MeSH
- prokain penicilin G aplikace a dávkování škodlivé účinky MeSH
- řízení kvality MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Aim: To compare nurses' and patients' reports of missed nursing care in surgical units. Design: A cross-sectional correlational study. Methods: The sample involved 130 nurses in surgical departments, and 112 patients assigned to nurses during various shifts were included. The Slovak version of the Missed Nursing Care Survey, the MISSCARE-Patient Survey, and the Generic Short Patient Experiences Questionnaire were used to collect data. Data were analyzed using descriptive and nonparametric inductive statistics. Results: The overall mean scores of the MISSCARE versions were low, suggesting a tendency for nurses and patients to perceive missed nursing care as a rarely occurring phenomenon. Patients' perceptions of specialist health care were positive, and only 20.7% of patients experienced any adverse events during hospitalization in surgical units. The nonsignificant relationship between nurses' and patients' reports of missed nursing care suggests differing perspectives on the amount and pattern of missed nursing care. A significant difference in the perception of missed nursing care in surgical wards was found among nurses but not among patients. A negative association between missed nursing care from the perspective of nurses and patients and various dimensions of patient-centered care was revealed. Conclusion: The study indicated a significant difference between nurses' and patients' perceptions and experiences of missed nursing care, highlighting the importance of including both perspectives.
BACKGROUND: Despite efforts to improve undergraduate clinical pharmacology & therapeutics (CPT) education, prescribing errors are still made regularly. To improve CPT education and daily prescribing, it is crucial to understand how therapeutic reasoning works. Therefore, the aim of this study was to gain insight into the therapeutic reasoning process. METHODS: A narrative literature review has been performed for literature on cognitive psychology and diagnostic and therapeutic reasoning. RESULTS: Based on these insights, The European Model of Therapeutic Reasoning has been developed, building upon earlier models and insights from cognitive psychology. In this model, it can be assumed that when a diagnosis is made, a primary, automatic response as to what to prescribe arises based on pattern recognition via therapy scripts (type 1 thinking). At some point, this response may be evaluated by the reflective mind (using metacognition). If it is found to be incorrect or incomplete, an alternative response must be formulated through a slower, more analytical and deliberative process, known as type 2 thinking. Metacognition monitors the reasoning process and helps a person to form new therapy scripts after they have chosen an effective therapy. Experienced physicians have more and richer therapy scripts, mostly based on experience and enabling conditions, instead of textbook knowledge, and therefore their type 1 response is more often correct. CONCLUSION: Because of the important role of metacognition in therapeutic reasoning, more attention should be paid to metacognition in CPT education. Both trainees and teachers should be aware of the possibility to monitor and influence these cognitive processes. Further research is required to investigate the applicability of these insights and the adaptability of educational approaches to therapeutic reasoning.
INTRODUCTION: The rapid advancement of artificial intelligence and big data analytics, including descriptive, diagnostic, predictive, and prescriptive analytics, has the potential to revolutionize many areas of medicine, including nephrology and dialysis. Artificial intelligence and big data analytics can be used to analyze large amounts of patient medical records, including laboratory results and imaging studies, to improve the accuracy of diagnosis, enhance early detection, identify patterns and trends, and personalize treatment plans for patients with kidney disease. Additionally, artificial intelligence and big data analytics can be used to identify patients' treatment who are not receiving adequate care, highlighting care inefficiencies in the dialysis provider, optimizing patient outcomes, reducing healthcare costs, and consequently creating values for all the involved stakeholders. OBJECTIVES: We present the results of a comprehensive survey aimed at exploring the attitudes of European physicians from eight countries working within a major hemodialysis network (Fresenius Medical Care NephroCare) toward the application of artificial intelligence in clinical practice. METHODS: An electronic survey on the implementation of artificial intelligence in hemodialysis clinics was distributed to 1,067 physicians. Of the 1,067 individuals invited to participate in the study, 404 (37.9%) professionals agreed to participate in the survey. RESULTS: The survey showed that a substantial proportion of respondents believe that artificial intelligence has the potential to support physicians in reducing medical malpractice or mistakes. CONCLUSION: While artificial intelligence's potential benefits are recognized in reducing medical errors and improving decision-making, concerns about treatment plan consistency, personalization, privacy, and the human aspects of patient care persist. Addressing these concerns will be crucial for successfully integrating artificial intelligence solutions in nephrology practice.
- MeSH
- dialýza ledvin MeSH
- lidé MeSH
- nefrologie * MeSH
- nefrologové MeSH
- průzkumy a dotazníky MeSH
- umělá inteligence * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Arrhythmogenic cardiomyopathy is an inherited cardiomyopathy characterized by fibrofatty replacement and a high risk of ventricular arrhythmias and sudden cardiac death. This myocardial disorder is typically transmitted through autosomal dominant pattern and caused by pathogenic variants in the desmosomal and extradesmosomal genes. In this case, we are presenting a family with three members who have arrhythmogenic left ventricular cardiomyopathy. The condition was found to be caused by a nonsense mutation (c.1754 T>G (p. Leu585Ter)) in the desmoplakin (DSP) gene. Unfortunately, two of the family members were initially misdiagnosed and treated for coronary artery disease, which was not the correct diagnosis. This case demonstrates the importance of accurate differential diagnosis and the usefulness of magnetic resonance imaging (MRI) in establishing the correct diagnosis of arrhythmogenic cardiomyopathy.
- MeSH
- anamnéza MeSH
- chybná diagnóza MeSH
- desmoplakiny genetika MeSH
- genetické testování MeSH
- ischemická choroba srdeční diagnóza MeSH
- kardiologické zobrazovací techniky MeSH
- kardiomyopatie * diagnostické zobrazování genetika vrozené MeSH
- lidé MeSH
- mladý dospělý MeSH
- mutace MeSH
- srdeční komory abnormality MeSH
- vrozené srdeční vady * diagnostické zobrazování genetika patofyziologie MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
Jessenius
263 stran : ilustrace ; 21 cm
Publikace, která se zaměřuje na použití elektrokardiografie v intenzivním a urgentním lékařství. Určeno odborné veřejnosti.
- MeSH
- chybná zdravotní péče MeSH
- elektrokardiografie MeSH
- farmakoterapie MeSH
- péče o pacienty v kritickém stavu MeSH
- urgentní lékařství MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- radiologie, nukleární medicína a zobrazovací metody
- anesteziologie a intenzivní lékařství
- kardiologie
- NLK Publikační typ
- kolektivní monografie
