Development and Usage Patterns of a Home-Grown Drug Information Tool.

Drug information tools help avoid medication errors, a common cause of avoidable harm in health care systems. We sought to describe the design, development process and architecture of an electronic drug information tool, as well as its overall use by health professionals. We developed a tool that can be accessed by all health professionals in a tertiary level university hospital. The functionalities of eDrugs are organized into two main parts: Drug Summary sheet, and Prescription Simulator. Most users accessed eDrugs to use the Drug summary sheet. Clinical information and antimicrobial drugs were the most accessed drug information and drug group. The analysis of log data provides insights into the information priorities of health professionals.

ZBTB16-RARα-Positive Atypical Promyelocytic Leukemia: A Case Report.

BACKGROUND: The majority of patients with acute promyelocytic leukemia (APL) manifest a specific chromosomal translocation t(15;17)(q22;q21), characterized by the fusion of RARA and PML genes. However, a proportion of APL cases are due to variant translocations, being t(11;17) (q23;q21) the most common amongst them. With the major exception of ZBTB16-RARA t(11;17) APL, these variant APL cases present similar morphological features as classic APL and are characterized by a lack of differentiation response to retinoids. CASE SUMMARY: We describe the case of variant APL with the ZBTB16-RARA fusion gene, showing a distinct morphology of classical APL, characterized by crystalline intracytoplasmic inclusions in both peripheral blood (PB) and bone marrow (BM) patients' blasts. Our patient was treated with two courses of intensive chemotherapy, initiating maintenance treatment with all-trans retinoic acid (ATRA) on day twenty-eight of the second course. Our patient achieved complete remission (CR) once the intensive chemotherapy was combined with ATRA. CONCLUSIONS: This is the second case described of APL with t(11;17) that showed crystalline intracytoplasmic inclusions. The finding of these morphological features may suggest the presence of a variant translocation with RARA, being that both cases described are related to the presence of t(11;17). Despite induction treatment with intensive chemotherapy that included a seven-day continuous treatment with cytarabine (200 mg/m2), plus daily idarubicin (12 mg/m2) during the first three days, our patient did not achieve complete remission (CR) until scheduled 3 + 7 regimen combined with ATRA treatment was established. This observation suggests that ATRA may be partially effective in some ZBTB16-RARA APLs.

Decision Support Tools for Drugs Prescription Process in a Hospital in Argentina.

While medications can improve the health of patients, the prescription process is complex and prone to errors. The structured medical order entry systems (CPOE) with clinical decision support (CDS) are increasingly implemented to improve patient safety, however the organizations that decide to implement them will have several challenges: understanding which classes of CDS can admit their systems, ensure that clinical knowledge is adequate and design tools for proper monitoring. We share our experience of over ten years of development and implementation of clinical decision support tools during drugs prescription process and tools that have allowed us to monitor them correctly.

Evaluating the Performance of a Terminology Search Engine Using Historical Data.

Clinical terms are noisy descriptions typed by healthcare professionals in Spanish language in the electronic health record system (EHR). Thus, an evaluation of terminology search engine that extends SNOMED CT and an approach that uses historical data of clinical terms is described. We show how to measure precision and recall using historical search data, and we show how the performance of the search engine can be improved significantly using the technology available in the search engine.

An Information Retrieval Approach to ICD-10 Classification.

ICD-10 (International Classification of Diseases 10th revision) is a classification code for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. This paper describes an automatic information retrieval approach to map free-text disease descriptions to ICD-10 codes. We use the Hospital Italiano de Buenos Aires (HIBA) terminology data mapped to ICD-10 codes as indexed data to find an appropriate ICD-10 code using search engine similarity metrics.

Selection of Semantic Relevant Healthcare Services Subsets.

We describe an approach to select semantically coherent specialty subsets based on the historical use of terminology by different service areas. Our approach uses rule-based and machine learning techniques to obtain a reduced set of 29 specialties.