A review of the most impactful published pharmacotherapy-pertinent literature of 2019 and 2020 for clinicians caring for patients with thermal or inhalation injury

2021 ◽  
Author(s):  
David M Hill ◽  
Allison N Boyd ◽  
Sarah Zavala ◽  
Beatrice Adams ◽  
Melissa Reger ◽  
...  
Keyword(s):  
Current Practice ◽  
Inhalation Injury ◽  
High Impact ◽  
Pertinent Literature ◽  
Resource Limitations ◽  
Geographically Dispersed ◽  
Primary Literature ◽  
Thermal Injuries ◽  
Potential Impact ◽  
Manual Review

Abstract Keeping abreast with current literature can be challenging, especially for practitioners caring for patients sustaining thermal or inhalation injury. Practitioners caring for patients with thermal injuries publish in a wide variety of journals, which further increases the complexity for those with resource limitations. Pharmacotherapy research continues to be a minority focus in primary literature. This review is a renewal of previous years’ work to facilitate extraction and review of the most recent pharmacotherapy-centric studies in patients with thermal and inhalation injury. Sixteen geographically dispersed, board-certified pharmacists participated in the review. A MeSH-based, filtered search returned 1,536 manuscripts over the previous 2-year period. After manual review and exclusions, only 98 (6.4%) manuscripts were determined to have a potential impact on current pharmacotherapy practices and included in the review. A summary of the 10 articles that scored highest are included in the review. Nearly half of the reviewed manuscripts were assessed to lack a significant impact on current practice. Despite an increase in published literature over the previous 2-year review, the focus and quality remain unchanged. There remains a need for investment in well-designed, high impact, pharmacotherapy-pertinent research for patients sustaining thermal or inhalation injuries.

Brain death in pregnancy: what will be left of the life of foetus?

2020 ◽  
Vol 69 (3) ◽  
pp. 281-291
Author(s):  
Matteo Gulino ◽  
Gianluca Montanari Vergallo ◽  
Rosagemma Ciliberti ◽  
Antonio G. Spagnolo
Keyword(s):  
Brain Death ◽  
Human Life ◽  
Rare Event ◽  
High Impact ◽  
Social Implications ◽  
Vital Functions ◽  
Clinical Consequences ◽  
Potential Impact ◽  
The Moment ◽  
In Pregnancy

Brain death in pregnancy (BDinP) has been described in literature as a “rare event” and “hopeless condition for patients”, who has a devastating potential to negatively affect the poetry of the moment of welcoming a new human life to the world. Clinical consequences of BDinP are extremely dangerous for the life of a foetus that, without prompt medical actions, is doomed to suffer the same fate as the mother. Modern medical techniques make it possible to maintain basic vital functions of the pregnant woman for months, in order to achieve a level of development of the foetus. Although maternal somatic support requires the consideration of specific medical parameters, from a bioethical standpoint, this option gives rise to multiple ethical and social implications. In this manuscript, we identify the main ethical and social implications about maternal somatic support, including the potential impact on the clinical practice of medical staff, and discuss some Italian high-impact media cases.* The authors contributed equally to the work.

scholarly journals Significant Published Articles for Pharmacy Nutrition Support Practice in 2018

2019 ◽  
Vol 54 (5) ◽  
pp. 285-293
Author(s):  
Roland N. Dickerson ◽  
Vanessa J. Kumpf ◽  
Angela L. Bingham ◽  
Allison B. Blackmer ◽  
Todd W. Canada ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pharmacy Practice ◽  
Nutrition Support ◽  
Professional Organizations ◽  
Pertinent Literature ◽  
High Importance ◽  
Clinical Pharmacists ◽  
Primary Literature

Purpose: The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2018 considered important to their clinical practice. The citation list was compiled into a single spreadsheet where the author participants were asked to assess whether the article was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby the majority of author participants (at least 5 of 8) considered the paper to be important. Guideline and consensus papers from professional organizations, important to practice but not scored, were also included. Results: A total of 117 articles were identified; 8 from the primary literature were voted by the group to be of high importance. An additional 13 organizational guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were reviewed. Conclusion: We recommend that pharmacists engaged in nutrition support therapy be familiar with these articles as it pertains to their practice.

711 A Retrospective Review of Enoxaparin Dosing Practices in Burn Patients

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S187-S187
Author(s):  
Asia N Quan ◽  
Aisha Aden ◽  
Claudia Islas ◽  
Karen J Richey ◽  
Kevin N Foster
Keyword(s):  
Current Practice ◽  
Retrospective Chart Review ◽  
Medication Administration ◽  
Inhalation Injury ◽  
Low Flow ◽  
Common Mechanism ◽  
Burn Patients ◽  
Dosing Regimen ◽  
Actual Weight ◽  
Starting Dose

Abstract Introduction Enoxaparin, a low molecular weight heparin, has been proven to safely and effectively prevent venous thromboembolism (VTE) in acutely ill patients. Burn patients may be particularly vulnerable to the occurrence of a VTE due to prolonged immobility, frequent operating room procedures, and low flow states. Treatment of acute VTE is associated with a direct medical cost of $12000-$15000 and subsequent complications increase costs to $18000 to $23000 per case. Current institutional protocol for initiation of enoxaparin an all burn adult patients is 40 mg administered subcutaneously every 12 hours. Anti-Xa levels are used to monitor anticoagulation prophylaxis, with 0.3–0.5 U/mL recognized as the prophylactic range. Doses are subsequently modified in 10 mg increments to achieve goal prophylaxis anti-Xa levles. The purpose of this study was to evaluate current practice (CP) and assess if the implementation of a published enoxaparin dosing algorithm could minimize delay in achieving anticoagulation prophylaxis. Methods A retrospective chart review was performed of 94 adult burn patients. The doses and time required to reach goal prophylaxis anti-Xa levels using current practice (CP) were compared to the predicted algorithm dose (AD). The number of dose adjustments and the number of days needed for adjustments for CP were documented. Charges related for laboratory determinations and medication administration were calculated. Results Of the 94 patients reviewed, the average age was 47 years, the majority were male (74%), mean actual weight 92 kilograms and mean TBSA 15.7%. The most common mechanism of injury was flash/flame (63%) with 18% suffering an inhalation injury. On average, using CP, it took 9.3 days to get to goal prophylaxis anti-Xa levels, with a mean of 2.86 anti-Xa lab tests needed and an average prophylactic dose of 55.5 mg. A total of 360 labs draws were performed and 74% were timed correctly. The CP average starting dose was lower than the AD 40 mg versus 45 mg (p < .0001). If the algorithm had been used the number of dosing adjustments would have been 25% less. The algorithm overestimated the starting dose in only 2.1% of the population. The average charges until goal was met for enoxaparin were $2,933 and $787 for anti-Xa levels. Conclusions This study demonstrates increased clinical efficacy and cost-effectiveness for an algorithm driven enoxaparin dosing regimen for burn patients. Prospective study with larger patient numbers is warranted. Applicability of Research to Practice Increased efficacy combined with decreased cost for an new enoxaparin dosing regimen.

scholarly journals Significant Published Articles for Pharmacy Nutrition Support Practice in 2019

2020 ◽  
Vol 55 (6) ◽  
pp. 373-381
Author(s):  
Roland N. Dickerson ◽  
Angela L. Bingham ◽  
Todd W. Canada ◽  
Lingtak N. Chan ◽  
M. Petrea Cober ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pharmacy Practice ◽  
Nutrition Support ◽  
Professional Organizations ◽  
Pertinent Literature ◽  
High Importance ◽  
Clinical Pharmacists ◽  
Primary Literature

Purpose The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2019 considered important to their clinical practice. The citation list was compiled into a single spreadsheet where the author participants were asked to assess whether the article was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby at least 5 out of the 8 author participants considered the paper to be important. Guideline and consensus papers from professional organizations, important to practice but not ranked, were also included. Results: A total of 111 articles were identified; 6 from the primary literature were voted by the group to be of high importance. An additional 9 organizational guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were summarized and a narrative regarding its implications to pharmacy nutrition support practice were provided. Conclusion: We recommend that pharmacists engaged in nutrition support therapy be familiar with these articles as it pertains to their practice.

Supply chain resilience to low-/high-impact disruptions: the influence of absorptive capacity

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Joseph Roh ◽  
Travis Tokar ◽  
Morgan Swink ◽  
Brent Williams
Keyword(s):  
Absorptive Capacity ◽  
High Impact ◽  
Industry Data ◽  
Supply Networks ◽  
Content Type ◽  
Supply Chain Resilience ◽  
Complex Interactions ◽  
Potential Impact ◽  
Resilience Capabilities ◽  
Different Levels

PurposeThe lean and global character of supply networks today opens supply chains to potential disruptions, especially in volatile environments. Most disruptions are of relatively low potential impact; however, firms also occasionally face high-impact disruptions that may even threaten survival. This study applies and extends absorptive capacity concepts to organize resilience capabilities identified in the literature and to examine whether capabilities that provide low-impact resilience are different from those that provide high-impact resilience. A second and related objective is to evaluate whether low-impact resilience supports high-impact resilience through “learning by experience.”Design/methodology/approachSurvey and industry data are used to understand capabilities involved with achieving both low-impact resilience and high-impact resilience.FindingsThe results of our analysis of survey and industry data uncover significant complex interactions in the effects of capabilities and volatility on resilience; suggesting that different absorptive capacity capabilities are related to low-impact resilience and high-impact resilience, respectively, and these effects depend on industry context. Moderating influences of exploitation capability and environmental volatility are consistent with a “learning by experience” explanation of the association of low-impact resilience to high-impact resilience.Originality/valueThis study thus provides a unifying framework with which to consider resiliency capabilities. Further, it answers a question raised in prior research, and it extends our understanding of important relationships between capabilities for different levels of resilience.

scholarly journals THE IMPACT OF STRUCTURAL AND COHESION FUNDS ON THE ECONOMY OF BIHOR COUNTY DURING 2007-2013 PROGRAMMING PERIOD

2018 ◽  
Vol 3 (Special) ◽  
pp. 74-83
Author(s):  
Felix-Angel Popescu
Keyword(s):  
European Commission ◽  
High Impact ◽  
Regional Level ◽  
Short Term ◽  
Model Simulations ◽  
Policy Level ◽  
Potential Impact ◽  
Programming Period ◽  
The Impact

The author uses TIATOOL model simulations, in order to reveal the potential impact generated by the Romanian Operational Programs 2007-2013 funded projects in Bihor county, on a set of 34 socio-economic indicators, for which individual intensities and weights were estimated by the author, based on the actual numbers of projects, their scope and the amounts of money absorbed by project beneficiaries. The readers should not expect a high impact of Structural and Cohesion funds on the economy of Bihor county, on short term, because these funds, like the rest of community funds, have a very pronounced redistributive role, which means that the dimension of the necessary expenditures for the implementation of projects counterbalances its revenues dimension, the amortization of such investments being made on long term. The novelty of such research is the fact that the Community authorities (in this case the European Commission) investigate the impact of Community funds only at policy level (cohesion, regional development and employment, territorial cooperation) and only in a comparative spectrum between national and regional figures, and the Romanian authorities (the Ministry of European Funds, the Operational Programs Managing Authorities) carry out impact assessments only at national and regional level.

Thermal Injuries

2015 ◽  
Author(s):  
Tatiana Havryliuk ◽  
Ryan Paterson
Keyword(s):  
Life Support ◽  
Chemical Exposure ◽  
The United States ◽  
Inhalation Injury ◽  
Burn Injuries ◽  
Initial Assessment ◽  
Advanced Trauma Life Support ◽  
Burn Patients ◽  
Medical Facilities ◽  
Thermal Injuries

In the United States, an estimated 450,000 patients with burns are treated in medical facilities annually. On assessment of burn patients, Advanced Trauma Life Support protocols should be followed because these patients often suffer from concomitant trauma; chemical exposure and airway compromise should also be considered in the initial assessment. Mortality from burn injuries increases with the patient’s age, the extent of the burn, and the presence of inhalation injury. This review covers the epidemiology, pathophysiology, assessment and stabilization, diagnosis, treatment and disposition, and outcomes of patients with burn injuries. Figures show the structure of the skin, and photographs of partial-thickness and full-thickness burns. Tables list burn classification by depth, indications for intubation, American Burn Association 2010 guidelines for calculating IV fluid resuscitation, indications for escharotomy in patients with circumferential trunk and extremity burns, and indications for burn center referral. This review contains 3 highly rendered figures, 5 tables, and 33 references.

scholarly journals Significant Published Articles for Pharmacy Nutrition Support Practice in 2016

2017 ◽  
Vol 52 (6) ◽  
pp. 412-421 ◽  
Author(s):  
Roland N. Dickerson ◽  
Vanessa J. Kumpf ◽  
Angela L. Bingham ◽  
Sarah V. Cogle ◽  
Allison B. Blackmer ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pharmacy Practice ◽  
Nutrition Support ◽  
Professional Organizations ◽  
Pertinent Literature ◽  
High Importance ◽  
Clinical Pharmacists ◽  
Primary Literature

Purpose: To assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2016 considered important to their clinical practice. The citation list was compiled into a single spreadsheet where the author participants were asked to assess whether the paper was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby the majority of author participants (at least 5 out of 8) considered the paper to be important. Guideline and consensus papers from professional organizations, important to practice but not scored, were also included. Results: A total of 103 articles were identified; 10 from the primary literature were voted by the group to be of high importance. An additional 11 organizational guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were reviewed. Conclusion: It is recommended that pharmacists, engaged in nutrition support therapy, be familiar with the majority of these articles as it pertains to their practice.

Characterization of variables for potential impact on vancomycin pharmacokinetics in thermal or inhalation injury

Burns ◽  
2018 ◽  
Vol 44 (3) ◽  
pp. 658-664 ◽  
Author(s):  
Katie Elder ◽  
David M. Hill ◽  
William L. Hickerson
Keyword(s):  
Inhalation Injury ◽  
Potential Impact
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