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  1. Article ; Online: COVID-19: Clean up on IL-6.

    Hedrick, Tanner L / Murray, Brian P / Hagan, Robert S / Mock, Jason R

    American journal of respiratory cell and molecular biology

    2020  Volume 63, Issue 4, Page(s) 541–543

    MeSH term(s) Betacoronavirus/drug effects ; Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/drug therapy ; Humans ; Interleukin-6/antagonists & inhibitors ; Interleukin-6/metabolism ; Pandemics ; Pneumonia, Viral/drug therapy ; SARS-CoV-2
    Chemical Substances Interleukin-6
    Keywords covid19
    Language English
    Publishing date 2020-08-25
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1025960-0
    ISSN 1535-4989 ; 1044-1549
    ISSN (online) 1535-4989
    ISSN 1044-1549
    DOI 10.1165/rcmb.2020-0277LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2851: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Impact of a multidisciplinary workflow on safety and management of patients with heparin-induced thrombocytopenia.

    Northam, Kalynn A / Chen, Sheh-Li / Stivers, Andrew P / Cicci, Jonathan D / Hedrick, Tanner L / Rollins-Raval, Marian A / Kasthuri, Raj S

    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

    2020  Volume 78, Issue 1, Page(s) 49–59

    Abstract: Purpose: Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin administration. Management strategies are complex and include discontinuing heparin products, initiating alternative anticoagulants, interpreting laboratory test ... ...

    Abstract Purpose: Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin administration. Management strategies are complex and include discontinuing heparin products, initiating alternative anticoagulants, interpreting laboratory test results, documenting heparin allergies, and providing patient education. Medication error reports and a retrospective review conducted at an academic medical center revealed an opportunity for a quality improvement initiative and led to the creation of a multidisciplinary workflow for the management of HIT. In a pre-post study, the impact of the multidisciplinary workflow on the safety and management of HIT was evaluated.
    Methods: The preimplementation group consisted of adult patients tested for suspected HIT from April 4, 2014, through May 31, 2016; the postimplementation group consisted of adult patients tested from November 1, 2016, through October 31, 2018. The primary outcome was the incidence of heparin product administration while HIT testing was ongoing. The secondary outcome was the rate of appropriate heparin allergy documentation.
    Results: The incidence of heparin product administration while HIT testing results were pending was significantly reduced, from 54.2% to 20.0% (P < 0.001), after workflow implementation. The rate of appropriate heparin allergy documentation significantly increased, from 95.0% to 100% (P < 0.001).
    Conclusion: Implementation of a multidisciplinary workflow for the management of HIT significantly reduced the incidence of heparin administration while testing was ongoing and improved the rate of appropriate heparin allergy documentation.
    MeSH term(s) Adult ; Anticoagulants/adverse effects ; Heparin/adverse effects ; Humans ; Male ; Patient Safety ; Retrospective Studies ; Thrombocytopenia/chemically induced ; Thrombocytopenia/diagnosis ; Thrombocytopenia/epidemiology ; Workflow
    Chemical Substances Anticoagulants ; Heparin (9005-49-6)
    Language English
    Publishing date 2020-10-21
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1224627-x
    ISSN 1535-2900 ; 1079-2082
    ISSN (online) 1535-2900
    ISSN 1079-2082
    DOI 10.1093/ajhp/zxaa342
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 419: Show issues Location:
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  4. Article ; Online: Evaluation of the Safety of Intravenous Thiamine Administration in a Large Academic Medical Center.

    Tjugum, Shelby L / Hedrick, Tanner L / Jean, Stephanie J / Heeney, Stephanie A / Rohde, Kalynn A / Campbell-Bright, Stacy L

    Journal of pharmacy practice

    2019  Volume 34, Issue 3, Page(s) 397–402

    Abstract: Background/objective: Previous literature describes increased incidence of infusion-related reactions when administering thiamine doses greater than 100 mg as an intravenous (IV) push. The purpose of this evaluation was to assess the safety of ... ...

    Abstract Background/objective: Previous literature describes increased incidence of infusion-related reactions when administering thiamine doses greater than 100 mg as an intravenous (IV) push. The purpose of this evaluation was to assess the safety of administering higher doses of thiamine as IV push compared to infusion.
    Methods: A single-center, retrospective review was performed from June to October 2017. Included patients were aged 18 years or older and received 1 dose of IV thiamine 200 mg or greater. Patients were divided into 2 groups: group 1 included patients who received 200-mg IV push and, group 2 included patients who received any dose greater than 200 mg. The primary objective was to quantify and compare rate of adverse reactions between the 2 groups. Institutional thiamine prescribing practices were examined. Wilcoxon Rank Sum and Fischer exact tests were performed.
    Results: Sixty-six percent of patients were male, and the median age was 55 years (interquartile range [IQR]: 44-63). Fifty percent received 200-mg IV push, 20% received a combination of IV infusion and IV push, and 30% received IV infusion. Adverse reactions possibly due to thiamine administration occurred in 4 (2.0%) patients. One patient received 200 mg via IV infusion, while 3 received 200 mg via IV push. There was no significant difference in adverse reaction rate between IV push and IV infusion administrations (
    Conclusion: Our results support administering thiamine doses of 200 mg or less as an IV push. Given lack of robust safety data, it is recommended to continue to dilute doses greater than 200 mg and infuse over 30 minutes.
    MeSH term(s) Academic Medical Centers ; Administration, Intravenous ; Adolescent ; Female ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Retrospective Studies ; Thiamine/adverse effects
    Chemical Substances Thiamine (X66NSO3N35)
    Language English
    Publishing date 2019-09-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1027474-1
    ISSN 1531-1937 ; 0897-1900
    ISSN (online) 1531-1937
    ISSN 0897-1900
    DOI 10.1177/0897190019872584
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2893: Show issues Location:
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  5. Article ; Online: Rapid analysis of local data to inform off-label tocilizumab use early in the COVID-19 pandemic.

    Morgan, Camille E / Rimland, Casey A / Bell, Griffin J / Kim, Min K / Hedrick, Tanner / Marx, Ashley / Bramson, Brian / Swygard, Heidi / Napravnik, Sonia / Schmitz, John L / Carson, Shannon S / Fischer, William A / Eron, Joseph J / Gay, Cynthia L / Parr, Jonathan B

    Healthcare (Amsterdam, Netherlands)

    2021  Volume 9, Issue 4, Page(s) 100581

    Abstract: The interleukin-6 receptor antagonist tocilizumab became widely used early in the coronavirus disease 2019 (COVID-19) pandemic based on small observational studies that suggested clinical benefit in COVID-19 patients with a hyperinflammatory state. To ... ...

    Abstract The interleukin-6 receptor antagonist tocilizumab became widely used early in the coronavirus disease 2019 (COVID-19) pandemic based on small observational studies that suggested clinical benefit in COVID-19 patients with a hyperinflammatory state. To inform our local treatment algorithms in the absence of randomized clinical trial results, we performed a rapid analysis of the first 11 hospitalized COVID-19 patients treated with tocilizumab at our academic medical center. We report their early clinical outcomes and describe the process by which we assembled a team of diverse trainees and stakeholders to extract, analyze, and disseminate data during a time of clinical uncertainty.
    MeSH term(s) Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy ; Clinical Decision-Making ; Cytokine Release Syndrome ; Humans ; Off-Label Use ; Pandemics ; SARS-CoV-2 ; Treatment Outcome ; Uncertainty
    Chemical Substances Antibodies, Monoclonal, Humanized ; tocilizumab (I031V2H011)
    Language English
    Publishing date 2021-09-09
    Publishing country Netherlands
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2724773-9
    ISSN 2213-0772 ; 2213-0764 ; 2213-0772
    ISSN (online) 2213-0772 ; 2213-0764
    ISSN 2213-0772
    DOI 10.1016/j.hjdsi.2021.100581
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Evaluation of gravimetric-based technology-assisted workflow for nonhazardous sterile product preparation.

    Bucci, Tyler G / Hedrick, Tanner L / Roberts, Patricia A / Lin, Kinny / South, Mark D / Willoughby, Ian R / Eckel, Stephen F / Hess, Elizabeth T / Eberwein, Samuel / Amerine, Lindsey B

    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

    2019  Volume 76, Issue 14, Page(s) 1071–1077

    Abstract: Purpose: The impact of a gravimetric-based technology-assisted workflow (TAWF) system on the nonhazardous compounded sterile product (CSP) error capture rate, production times, and pharmacy staff perceptions of compounding methods was evaluated.: ... ...

    Abstract Purpose: The impact of a gravimetric-based technology-assisted workflow (TAWF) system on the nonhazardous compounded sterile product (CSP) error capture rate, production times, and pharmacy staff perceptions of compounding methods was evaluated.
    Methods: For 2 weeks prior to TAWF implementation, staff used a punch clock to document production times with a volumetric method. Preimplementation error data were captured in a previous study; TAWF software captured error and time data in the postimplementation period. An online staff survey was administered before and 90 days after TAWF implementation to evaluate perceptions of the 2 methods.
    Results: The error capture rates were 0.47% in the preimplementation period and 41.48% in the postimplementation period. The median time to prepare CSPs was significantly shorter in the preimplementation period versus the postimplementation period (p < 0.0001). The median time to check CSPs was significantly shorter at both 90 days (p < 0.0001) and 180 days (p = 0.0006) after TAWF implementation. When asked if the current method was the safest and the most accurate method for preparation, staff members' perceptions improved from neutrality to agreement when the TAWF was implemented. Staff members were in agreement that the volumetric method was faster than the gravimetric TAWF method but were neutral as to whether the latter was the preferred compounding method.
    Conclusion: The study results indicated that gravimetric-based TAWF preparation of nonhazardous CSPs is slower than manual volumetric preparation but can improve the error capture rate. Staff perceived the gravimetric TAWF method to be the safest and most accurate for producing CSPs.
    MeSH term(s) Chemistry Techniques, Analytical/methods ; Chemistry, Pharmaceutical/methods ; Drug Compounding/methods ; Humans ; Medication Errors/prevention & control ; Pharmacy Service, Hospital/organization & administration ; Software ; Time Factors ; Workflow
    Language English
    Publishing date 2019-07-30
    Publishing country England
    Document type Evaluation Study ; Journal Article
    ZDB-ID 1224627-x
    ISSN 1535-2900 ; 1079-2082
    ISSN (online) 1535-2900
    ISSN 1079-2082
    DOI 10.1093/ajhp/zxz097
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 419: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Clinical characteristics and early outcomes in patients with COVID-19 treated with tocilizumab at a United States academic center

    Rimland, Casey Allison / Morgan, Camille E / Bell, Griffin J / Kim, Min K / Hedrick, Tanner / Marx, Ashley / Bramson, Brian / Napravnik, Sonia / Schmitz, John L / Carson, Shannon S / Fischer, William A / Eron, Joseph J / Gay, Cynthia L / Parr, Jonathan B

    medRxiv

    Abstract: ... reactive protein levels decreased in all patients following treatment (median 211.6 pre- vs. 19.7 mg/L 5 ...

    Abstract Limited evidence is available to guide treatment of coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A hyperinflammatory state mediated by interleukin-6 (IL-6) has been proposed as a driver of severe disease. Use of the IL-6 receptor inhibitor tocilizumab for severe COVID-19 was first reported in China, where a case series described marked improvements in inflammatory markers, fever, oxygen requirement, and outcomes following its administration. Here, we provide the first description of a tocilizumab-treated cohort of patients with COVID-19 in the United States. We describe 11 patients from a single academic medical center, nine (82%) of whom were critically ill requiring mechanical ventilation in an intensive care unit at the time of tocilizumab administration. C-reactive protein levels decreased in all patients following treatment (median 211.6 pre- vs. 19.7 mg/L 5 days post-tocilizumab [p=0.001]). When IL-6 levels were obtained before and after therapy, wide variation was seen in baseline levels; post-dose IL-6 concentrations were consistently increased. In contrast to prior reports, we did not observe significant clinical improvement in temperature or oxygen requirements in most patients. Two patients were discharged (18%), five remained in critical condition in the intensive care unit (46%), one was weaned off the ventilator to room air (9%), and three died (27%). Our findings suggest that tocilizumab should be used with caution in severe and critically ill patients and highlight the need for data from randomized controlled trials to determine its efficacy in the treatment of COVID-19.
    Keywords covid19
    Language English
    Publishing date 2020-05-19
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.05.13.20100404
    Database COVID19

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  8. Article ; Online: From simulation to separation surgery: a tale of two twins.

    Simpao, Allan F / Wong, Robert / Ferrara, Tanna J / Hedrick, Holly L / Schwartz, Alan Jay / Snyder, Tiffany L / Tharakan, Sasha J / Bailey, Philip D

    Anesthesiology

    2014  Volume 120, Issue 1, Page(s) 110

    MeSH term(s) Anesthesia ; Female ; Humans ; Infant ; Manikins ; Patient Care Team ; Thorax/abnormalities ; Twins, Conjoined/surgery
    Language English
    Publishing date 2014-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 269-0
    ISSN 1528-1175 ; 0003-3022
    ISSN (online) 1528-1175
    ISSN 0003-3022
    DOI 10.1097/ALN.0b013e31828e13d6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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