A new complication registration system for errors in radiology: Initial 5-year experience in a tertiary care radiology department.
Eur J Radiol. 2020 Jul 09;130:109167
Authors: Carrara M, Yakar D, Kasalak Ö, Kwee TC
PURPOSE: To describe and evaluate our initial 5-year experience with a new complication registration system for errors in radiology.
MATERIALS AND METHODS: This study reviewed all cases that were submitted to a new complication registration system of a tertiary care radiology department between 2015-2019.
RESULTS: Sixty-seven cases were included. In the group of diagnostic complications/errors (n = 34), there were 21 perceptual errors and 13 cognitive errors. This 61.8 % (21/34) perceptual error rate was not significantly different (P = 0.297) from the 70 % perceptual error rate known from previous literature. In the group of interventional complications (n=19), most cases (47.4 % [9/19]) concerned symptomatic or major hemorrhage. In the group of organizational complications/errors (n=14), the leading incident type according to the International Classification System for Patient Safety was clinical process/procedure with wrong body part/side/site as subclassification (35.7 % [5/14]). Harm severities were none (n=35), mild (n=10), moderate (n=10), severe (n=6), death (n=5), and unknown (n=1). Harm severity of interventional complications was significantly higher (P < 0.05) than that of organizational complications, while there were no significant differences in harm severities between other groups of complications.
CONCLUSION: It is feasible to implement the radiologic complication registration system that was described in this study. Perceptual mistakes, hemorrhage, and procedures on the wrong body part/side/site dominated in the categories of diagnostic, interventional, and organizational complications/errors, respectively, and these should be the topic of vigilance in clinical practice and further research. Future studies are also required to determine whether this complication registration system reduces radiologic errors and improves healthcare quality.
PMID: 32682253 [PubMed – as supplied by publisher]
Posted in Eur J Radiol
Rational use of 18F-FDG PET/CT in patients with advanced cutaneous melanoma: A systematic review.
Crit Rev Oncol Hematol. 2020 Jul 01;153:103044
Authors: Bisschop C, de Heer EC, Brouwers AH, Hospers GAP, Jalving M
18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is increasingly used in patients with advanced melanoma. Immune checkpoint inhibitors and BRAF/MEK-targeted therapy have transformed the therapeutic landscape of metastatic melanoma. Consequently, a need for markers predicting (early) response to treatment and for monitoring treatment (toxicity) has arisen. This systematic review appraises the current literature evidence for rational use of 18F-FDG PET/CT scans in staging, clinical decision-making, treatment monitoring and follow-up in advanced melanoma. 18F-FDG PET/CT has high overall accuracy for detection of distant metastases and is, combined with cerebral MRI, the preferred imaging strategy for staging metastatic melanoma. In contrast, strong evidence supporting the standard use of 18F-FDG PET/CT for predicting and monitoring therapy response and toxicity is currently lacking. Essential for determining the position of 18F-FDG PET/CT during treatment course in advanced melanoma are well-designed studies with standardized scanning protocols, incorporation of clinical parameters and comparison with contrast-enhanced CT alone.
PMID: 32673997 [PubMed – as supplied by publisher]
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Hemostatic Changes of Acute Kidney Injury in Patients With Cirrhosis: What Do They Mean?
Hepatology. 2020 Jul 04;:
Authors: Lisman T
Historically, patients with liver disease were considered to have a bleeding tendency that was a consequence of changes in their hemostatic system. An important consequence of this concept is the ever-ongoing policy of prophylactic blood product transfusion prior to invasive procedures aimed to reduce bleeding risk. However, it is increasingly acknowledged that although bleeding in patients with liver diseases can be the consequence of a (temporal) hypocoagulable state, it is frequently unrelated to hemostatic failure and rather caused by portal hypertension (e.g., variceal bleeding) or inadvertent laceration of a blood vessel (e.g., during liver biopsy or paracentesis).
PMID: 32623738 [PubMed – as supplied by publisher]
Posted in Hepatology
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Advances of epigenetic editing.
Curr Opin Chem Biol. 2020 Jun 29;57:75-81
Authors: Gjaltema RAF, Rots MG
Epigenetic editing refers to the locus-specific targeting of epigenetic enzymes to rewrite the local epigenetic landscape of an endogenous genomic site, often with the aim of transcriptional reprogramming. Implementing clustered regularly interspaced short palindromic repeat-dCas9 greatly accelerated the advancement of epigenetic editing, yielding preclinical therapeutic successes using a variety of epigenetic enzymes. ,CRISPR/dCas9 Here, were review the current applications of these epigenetic editing tools in mammalians and shed light on biochemical improvements that facilitate versatile applications.
PMID: 32619853 [PubMed – as supplied by publisher]
Posted in Report
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Nanomedicine in Thrombosis and Hemostasis: The Future of Nanotechnology in Thrombosis and Hemostasis Research and Clinical Applications.
Semin Thromb Hemost. 2020 Jul;46(5):521-523
Authors: Hagemeyer CE, Lisman T, Kwaan HC
PMID: 32604418 [PubMed – as supplied by publisher]