scholarly journals Ongoing Use of SSRIs Does Not Alter Outcome in Hospitalized COVID-19 Patients: A Retrospective Analysis

2021 ◽  
Vol 11 (1) ◽  
pp. 70
Author(s):  
Steven H. Rauchman ◽  
Sherri G. Mendelson ◽  
Courtney Rauchman ◽  
Lora J. Kasselman ◽  
Aaron Pinkhasov ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Symptom Severity ◽  
Medical Records ◽  
Logistic Regression Model ◽  
Clinical Information ◽  
Infectious Agents ◽  
Clinical Databases ◽  
Significant Difference ◽  
Ssri Treatment ◽  
Age Category

SARS-CoV-2 continues to have devastating consequences worldwide. Though vaccinations have helped reduce spread, new strains still pose a threat. Therefore, it is imperative to identify treatments that prevent severe COVID-19 infection. Recently, acute use of SSRI antidepressants in COVID+ patients was shown to reduce symptom severity. The aim of this retrospective observational study was to determine whether COVID+ patients already on SSRIs upon hospital admission had reduced mortality compared to COVID+ patients not on chronic SSRI treatment. Electronic medical records of 9044 patients with laboratory-confirmed COVID-19 from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure. In this sample, no patients admitted on SSRIs had them discontinued. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs. those not taking SSRIs, after controlling for age category, gender, and race. This study shows the utility of large clinical databases in determining what commonly prescribed drugs might be useful in treating COVID-19. During pandemics due to novel infectious agents, it is critical to evaluate safety and efficacy of drugs that might be repurposed for treatment.

scholarly journals Ongoing use of SSRIs and the hospital course of COVID-19 patients: a retrospective outcome analysis

2021 ◽  
Author(s):  
Steven H. Rauchman ◽  
Sherri G. Mendelson ◽  
Courtney Rauchman ◽  
Lora J. Kasselman ◽  
Aaron Pinkhasov ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Large Sample Size ◽  
Gender And Race ◽  
Clinical Databases ◽  
Significant Difference ◽  
The Impact ◽  
Ssri Treatment ◽  
Age Category

Background: The SARS-CoV2 virus continues to have devastating consequences worldwide. Though vaccinations have helped to reduce the impact of the virus, new strains still pose a threat to unvaccinated, and to a lesser extent vaccinated, individuals. Therefore, it is imperative to identify treatments that can prevent the development of severe COVID-19. Recently, acute use of SSRI antidepressants in COVID+ patients has been shown to reduce the severity of symptoms compared to placebo. Since SSRIs are a widely used anti-depressant, the aim of this study was to determine if COVID+ patients already on SSRI treatment upon admission to the hospital had reduced mortality compared to COVID+ patients not on chronic SSRI treatment. Methods: A retrospective observational study design was used. Electronic medical records of 9,043 patients with a laboratory-confirmed diagnosis of Covid-19 from 03/2020 to 03/2021from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure. An adjusted logistic regression model was run to account for age category, gender, and race. All tests were considered significant at p of 0.05 or less. Results: In this sample, no patients admitted on SSRIs had them discontinued. This is consistent with current recommendations. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs COVID+ patients not taking SSRIs, after controlling for age category, gender, and race. The odds of COVID+ patients on SSRIs dying was 0.98 (95%CI: 0.81, 1.18) compared to COVID+ patients not on SSRIs (p=0.83). Conclusion: In times of pandemics due to novel infectious agents it is difficult, but critical to evaluate safety and efficacy of drugs that might be repurposed for treatment. This large sample size of 9,043 patients suggests that there will be no significant benefit to use of SSRIs to decrease mortality rates for hospitalized patients with Covid-19 who are not currently on SSRI medications. This study shows the utility of large clinical databases in addressing the urgent issue of determining what commonly prescribed drugs might be useful in treating COVID-19.

Informed Consent and Biobanks

2005 ◽  
Vol 33 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Ellen Wright Clayton
Keyword(s):  
Information Technology ◽  
Informed Consent ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Information ◽  
Information Resources ◽  
Biomedical Science ◽  
Research Setting ◽  
The Past

Biomedical research has always relied on access to human biological materials and clinical information, resources that when combined form biobanks. In the past, it appears that investigators sometimes used these resources with relatively little oversight, and without the consent of the individuals from whom these materials and information were obtained. Several developments in the last ten to fifteen years have converged to place greater emphasis on the role of individual consent in the creation and use of biobanks. The most important by far is the power of information technology, which has transformed our lives in almost every domain. In the research setting, it is now easy to abstract information from electronic medical records. Computers make it possible to analyze enormous datasets and have contributed in essential ways to the dramatic increases in our understanding of genomics and other areas of biomedical science.

scholarly journals Clinician-Dermatopathologist Communication via the Requisition Form in the Era of Electronic Medical Records: A Review of the Literature

2020 ◽  
Vol 4 (1) ◽  
pp. 15-22
Author(s):  
Haley Danielle Heibel ◽  
Clay J. Cockerell
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
English Language ◽  
Formal Education ◽  
Clinical Information ◽  
Cost Effective ◽  
Work Flow ◽  
Review Of The Literature ◽  
Study Designs ◽  
User Friendly

Background:  There are shortcomings in the quality and accuracy of submitted clinical information on skin biopsy requisition forms (SBRFs).  Most SBRFs are completed via electronic medical records (EMR), and the effect of this on the work flow and the quality of submitted clinical information must be evaluated to identify targets in clinician-dermatopathologist communication for improvement.Objective: This review of the literature explored how SBRFs are currently handled by clinicians in the context of EMR, barriers to effective clinician-dermatopathologist communication, and suggestions for improvement.Methods: A literature search was conducted on Medline, Cinahl, and Scopus including the keywords of dermatology*, dermapatholog*, dermatopathology*, and requisition*.  20 articles were retrieved.  17 articles were included from this search and from cross-referencing articles.Results:  This review reaffirmed the inadequacy of clinical information provided to dermatopathologists.  Standardization of and formal education in completing SBRFs, along with dermatopathologist access to information and images via shared EMR may improve histopathologic interpretation of specimens and allow for cost-effective patient care.Limitations: This review was restricted to the English language.  Previous studies have primarily been retrospective study designs and survey studies.Conclusion: The development of user-friendly standardized SBRFs with validated criteria are necessary.  Clinician awareness of how to appropriately convey information and terminology on the SBRF may significantly improve the work flow of both clinicians and dermatopathologists and patient outcomes.

A Bio-Psycho-Social Review of Usability Methods and their Applications in Healthcare

2011 ◽  
pp. 1874-1899 ◽  
Author(s):  
Morgan Price
Keyword(s):  
Information Systems ◽  
Social Interactions ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Information ◽  
Hospital Information Systems ◽  
The Other ◽  
Clinical Information Systems ◽  
Complete Understanding

The purpose of this chapter is to provide the reader with an overview of several models and theories from the general HCI literature, highlighting models at three levels of focus: biomechanical interactions, individual-cognitive interactions, and social interactions. This chapter will also explore how these models were or could be applied to the design and evaluation of clinical information systems, such as electronic medical records and hospital information systems. Finally, it will conclude with how an understanding at each level compliments the other two in order to create a more complete understanding of the interactions of information systems in healthcare.

Simplified and improved fluid deprivation test for diagnosing diabetes insipidus

2021 ◽  
Vol 184 (1) ◽  
pp. 123-131
Author(s):  
Anna Sjöström ◽  
Inga Bartuseviciene ◽  
Charlotte Höybye
Keyword(s):  
Data Collection ◽  
Diabetes Insipidus ◽  
Medical Records ◽  
Clinical Information ◽  
Urine Osmolality ◽  
Study Group ◽  
Median Serum ◽  
Significant Difference ◽  
Design And Methods ◽  
Serum And Urine

Objective The challenge of finding patients with the rare conditon of diabetes insipidus in need of vasopressin treatment is demanding. The guidelines for performing the fluid deprivation test and interpreting the results are abundant. We evaluated the discriminative capacity of the fluid deprivation test in patients with polyuria to define a cut off for a more effective discrimination between diabetes insipidus and other polyuria syndromes. Research design and methods Retrospective review and data collection of all ambulatory fluid deprivation tests, of patients with mild polyuria and polydipsia (< 3 L/day), performed between 2000 and 2018. Serum osmolality, urine osmolality, urine volumes and clinical information of diagnosis were retrieved from the patient’s medical records. Results The study group consisted of 153 patients, 123 were diagnosed with non-diabetes insipidus and 30 with diabetes insipidus. After 12 h fasting (baseline) median duration of the fluid deprivation test was 5 h (fasting range: 12–21 h). At baseline, there was a significant difference between median serum and urine osmolality between the groups (P < 0.05). The best cut-off for the diagnosis of diabetes insipidus, was the combination of < 400 mosmol/kg in urine and > 302 mosmol/kg in serum. With this cut-off a sensitivity of 90% and specificity of 98% was achieved. Conclusion After 12 h fasting our proposed cut off clearly differentiated between diabetes insipidus, and non-diabetes insipidus suggesting a possibility to considerably reduce the duration of the fluid deprivation test.

scholarly journals A Hybrid Method to Extract Clinical Information From Chinese Electronic Medical Records

IEEE Access ◽  
2019 ◽  
Vol 7 ◽  
pp. 70624-70633 ◽  
Author(s):  
Ming Cheng ◽  
Liming Li ◽  
Yafeng Ren ◽  
Yinxia Lou ◽  
Jianbo Gao
Keyword(s):  
Electronic Medical Records ◽  
Hybrid Method ◽  
Medical Records ◽  
Clinical Information

scholarly journals Gastrointestinal Adverse Events in Hospitalized Patients Following Orthopedic Surgery: Tapentadol Immediate Release Versus Oxycodone Immediate Release

2021 ◽  
pp. E309-E315
Author(s):  
Asad E. Patanwala
Keyword(s):  
Postoperative Pain ◽  
Electronic Medical Records ◽  
Orthopedic Surgery ◽  
Medical Records ◽  
Adverse Drug Events ◽  
Immediate Release ◽  
Orthopedic Procedures ◽  
Study Cohort ◽  
Tertiary Referral Hospital ◽  
Significant Difference

Background: Tapentadol has relatively less effect on μ-opioid receptors compared with other opioids. This has the potential to reduce the occurrence of gastrointestinal (GI) adverse drug events (ADEs). Objectives: To compare the GI ADEs during hospitalization between tapentadol immediate release (IR) and oxycodone IR following orthopedic surgeries. Study Design: Retrospective cohort study. Setting: A major metropolitan tertiary referral hospital in Australia. Methods: Data for adult orthopedic surgery patients receiving postoperative tapentadol IR or oxycodone IR during hospitalization between January 1, 2018 and June 30, 2019, were collected from electronic medical records. The primary outcome was the occurrence of postoperative GI ADEs occurring during hospitalization. This was defined as a composite of nausea, vomiting, or constipation. Results: The study cohort included 199 patients. Of these, 99 patients received tapentadol IR and 100 patients received oxycodone IR for postoperative pain during hospitalization. The mean age was 66 ± 12 years, and 111 patients (56%) were women. There was no significant difference between groups on the occurrence of GI ADEs (53% in oxycodone group and 51% in tapentadol group, difference 2%, 95% confidence interval [CI], –11% to 16%; P = 0.777). After adjusting for potential confounders, the use of tapentadol IR was not associated with a significant reduction of GI ADEs (odds ratio, 0.62; 95% CI, 0.32–1.20; P = 0.154). Limitations: This was a single-center study and should be extrapolated with caution. As this was a retrospective study, the accuracy and availability of data were dependent on documentation in electronic medical records. Conclusions: Tapentadol IR is associated with similar GI ADE occurrence compared with oxycodone IR in patients with orthopedic postoperative pain during hospitalization. Key words: Opioid analgesics, tapentadol, oxycodone, orthopedic procedures, postoperative pain, acute pain, gastrointestinal adverse drug events, opioid-induced adverse drug events

scholarly journals Renal Replacement Therapy and Concurrent Fluconazole Therapy Increase Linezolid-Related Thrombocytopenia Among Adult Patients

2021 ◽  
Author(s):  
Yueh-Chun Hsu ◽  
Szu-Ying Chen ◽  
Yung-Jun Hung ◽  
Yu-Wei Huang
Keyword(s):  
Risk Factors ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Binary Logistic Regression ◽  
Limited Information ◽  
Significant Difference ◽  
Fluconazole Therapy

Abstract Linezolid has been reported to be associated with thrombocytopenia. However, limited information is available on susceptibility to thrombocytopenia after linezolid usage. We aimed to investigate the risk factors for linezolid-associated thrombocytopenia (LAT). We conducted a retrospective cohort study of patients aged ≥ 18 years who received linezolid for ≥ 5 d during hospitalization in 2019. Information was extracted from electronic medical records. Thrombocytopenia was defined as a platelet count of < 100×109/L or a reduction from baseline ≥ 25%. Binary logistic regression and survival analyses were used to evaluate the risk factors for LAT. A total of 98 patients were enrolled. Thrombocytopenia occurred in 53.1% patients, with a median of 9 d after initiation of linezolid. There was no significant difference in the mortality or proportion of platelet transfusions between patients with and without thrombocytopenia. A higher risk of LAT was found in patients who received renal replacement therapy (RRT) (OR 4.8 [1.4–16.4]), concurrent fluconazole (OR 3.5 [1.2–9.8]), or a longer duration of linezolid treatment (OR 1.1 [1.0-1.1]). Patients who received RRT (8 vs. 15 d) or concurrent fluconazole (11 vs. 15 d) had a shorter median time to develop thrombocytopenia. Those who simultaneously received RRT and fluconazole had the shortest median of time (6.5 d) and the highest risk of developing thrombocytopenia (87.5%).

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