Drug, Healthcare and Patient Safety最新文献

{"title":"Chemotherapy-Induced Toxicities in Pediatric Cancer Patients in Tanzania [Letter].","authors":"Stanley Mwita","doi":"10.2147/DHPS.S624450","DOIUrl":"10.2147/DHPS.S624450","url":null,"abstract":"","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"624450"},"PeriodicalIF":4.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metoclopramide and Risk of Pheochromocytoma Crisis: A Causality Assessment Using Literature and VigiBase Data.","authors":"Merhawi Bahta, Abraham Dawit, Million Okubazghi, Mulugeta Russom","doi":"10.2147/DHPS.S593970","DOIUrl":"10.2147/DHPS.S593970","url":null,"abstract":"<p><strong>Introduction: </strong>The association between metoclopramide and pheochromocytoma crisis has been documented in literature. However, evidence has primarily relied on case reports and small-scale experimental studies rather than rigorous causal assessments. Therefore, this study aimed to assess the causal relationship between metoclopramide use and the occurrence of pheochromocytoma crisis by analyzing data from the literature and World Health Organization (WHO) global pharmacovigilance database.</p><p><strong>Methods: </strong>This study was a descriptive analysis and causality assessment of metoclopramide and pheochromocytoma crisis. Data were retrieved from published literature and the WHO global pharmacovigilance database (VigiBase) on February 13, 2025. In addition to the causality results extracted from VigiBase, causality assessment at the individual level for published case reports was conducted using the Naranjo Adverse Drug Reaction Probability Scale. Causality assessment at the population level was conducted using the Austin Bradford-Hill causality assessment framework.</p><p><strong>Results: </strong>A total of 62 de-duplicate cases were found in VigiBase and the literature. Almost all cases were classified as serious with 12 fatalities. In many instances, the drug-induced crisis served as the first clinical indication of an undiagnosed (occult) tumor. A causality assessment using the Naranjo algorithm conducted by the current authors classified the 18 published cases as \"probable\" (13) and \"possible\" (5). In VigiBase, causality assessment at the individual level was reported for 10 cases, with possible (6), probable (2), and reasonable possibilities (2). The results of the causality assessment at the population level using Hill's criteria revealed compelling evidence across all nine criteria.</p><p><strong>Conclusion: </strong>A reasonable causal relationship exists between metoclopramide and pheochromocytoma crisis, supporting its contraindication in patients with known or suspected pheochromocytoma.Clinicians should monitor patients, consider underlying pheochromocytoma, and be aware of this risk. Further international case-control studies are recommended to confirm this causal association.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"593970"},"PeriodicalIF":4.3,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paracetamol Overdose in Somali Children Under Five: An Emerging Public Health Concern.","authors":"Widad Mohamed Hassan","doi":"10.2147/DHPS.S607702","DOIUrl":"10.2147/DHPS.S607702","url":null,"abstract":"<p><p>Paracetamol (acetaminophen) is widely used for pain and fever management in children under five; however, accidental overdose is an increasing public health concern in low-resource settings such as Somalia. This narrative review highlights key risk factors, clinical consequences, and prevention strategies relevant to the Somali context based on published literature. Misconceptions about dosing, reliance on age rather than weight, and unrestricted access contribute to inappropriate administration and increased risk of hepatotoxicity and acute liver failure. While metabolic pathways in young children differ from adults, increased vulnerability in this setting is more strongly associated with malnutrition, dosing errors, and delayed access to healthcare. Toxicity results from accumulation of N-acetyl-p-benzoquinone imine (NAPQI), leading to oxidative stress and liver injury. Early treatment with N-acetylcysteine (NAC) is essential, yet delayed presentation and limited availability of antidotes in Somalia worsen outcomes. There is currently limited published data on the incidence of paracetamol overdose and NAC availability in Somalia. Strengthening caregiver education, pharmacy-based counseling, access to essential antidotes, and national poison surveillance systems is critical to reducing preventable pediatric liver injury in Somalia.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"607702"},"PeriodicalIF":4.3,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148014137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Outcomes of Naloxone Use for Iatrogenic Opioid Overdose in Patients on General Wards in a Swiss Hospital: A Ten-Year Retrospective Case Series Analysis.","authors":"Maurice Würsten, Carla Meyer-Massetti, Anne Leuppi-Taegtmeyer, Aljoscha N Goetschi","doi":"10.2147/DHPS.S607184","DOIUrl":"10.2147/DHPS.S607184","url":null,"abstract":"<p><strong>Introduction: </strong>Opioids carry an inherent high risk of adverse drug events (ADEs), although these are generally predictable and avoidable through proper management and monitoring. Naloxone, an opioid antagonist, is used to counteract severe opioid overdoses.</p><p><strong>Aim: </strong>This study aimed to estimate the incidence of iatrogenic opioid overdoses and describe prescribing patterns before, during and after them.</p><p><strong>Methods: </strong>We conducted a ten-year retrospective case series analysis of naloxone use among inpatients at a large, multisite university hospital in Switzerland from January 2014 to December 2023. Cases were included if an adult patient had received naloxone after opioid administration and overdose. We excluded patients who received naloxone during surgery or in intensive care units.</p><p><strong>Results: </strong>Of the 671 uses of naloxone identified, 121 (18.0%) met our inclusion criteria. Yearly naloxone use incidence was 11.0 per 10,000 inpatients, increasing slightly from 2014 to 2023. The median daily opioid dose requiring naloxone was 73 morphine milligram equivalents (MME). According to the Schumock and Thornton scale criteria, we considered 82 (67.8%) of the 121 opioid overdoses to have been potentially preventable The median opioid doses received before hospital admission (29.4 MME) were higher than at discharge (15.0 MME). Nevertheless, 71 (68.3%) of 104 discharged patients were still prescribed at least one opioid.</p><p><strong>Conclusion: </strong>This study found that iatrogenic opioid overdoses were relatively uncommon. However, the considerable number of preventable opioid overdoses estimated leads us to conclude that opioid stewardship programmes should be recommended across Switzerland.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"607184"},"PeriodicalIF":4.3,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography Diagnostic Reference Levels Worldwide and in Jordan: Implications for Patient Dose Reduction.","authors":"Ammar A Oglat, Suhaib Shdaifat, Mohannad Adel Sayah, Ahmed Abukonna, Wadah M Ali Khogali","doi":"10.2147/DHPS.S595721","DOIUrl":"10.2147/DHPS.S595721","url":null,"abstract":"<p><p>Computed tomography (CT) contributes substantially to medical radiation exposure, making diagnostic reference levels (DRLs) essential for dose optimization and patient protection. This narrative review summarizes international CT DRL practices and examines the current status of DRL development in Jordan. Published studies and key guidance documents addressing adult and pediatric CT DRLs, including CTDIvol, dose-length product (DLP), and size-specific dose estimate (SSDE) where available, were reviewed to identify common implementation approaches, frequently used dose metrics, and evidence gaps relevant to Jordan. The reviewed literature shows marked inter-country variation in DRL methodology, updating cycles, and regulatory integration. In Jordan, available studies demonstrate useful local and multicenter data, but routine CT practice still lacks a unified national DRL framework. Reported Jordanian values also show inter-institutional variability, highlighting the need for standardized data collection, regular auditing, and coordinated national oversight. Establishing national DRLs based on transparent methodology and periodic revision would strengthen radiation protection, improve protocol consistency, and support safer CT practice in Jordan.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"595721"},"PeriodicalIF":4.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exosome Therapy for Livedoid Vasculitis Following COVID-19 Vaccination: A Case Report.","authors":"Tsung-Kun Lin, Chih-Feng Chang, Gwo-Ping Jong","doi":"10.2147/DHPS.S596013","DOIUrl":"10.2147/DHPS.S596013","url":null,"abstract":"<p><p>Livedoid vasculitis is a vascular autoimmune disorder affecting the skin. It most commonly occurs in young women. The occurrence of this condition after the coronavirus 2019 (COVID-19) vaccination is rare. The available literature suggests limited use of exosomes in the treatment of livedoid vasculitis. We present the case of a 65-year-old Chinese man who developed livedoid vasculitis after COVID-19 vaccination. We posit that the etiology in this case may be either COVID-19 vaccine-induced immune stimulation or activation of the condition by a rare vaccine component. This case is unique, with no previously reported precedents. The patient was treated intravenously for 1 month with stem cell-derived exosome therapy, using stem cells derived from exfoliated human deciduous teeth. This resulted in improvement in the livedoid vasculitis, with no reemergence of symptoms. This case highlights the therapeutic benefits of exosome treatment for livedoid vasculitis after COVID-19 vaccination. However, large-scale studies are needed before this outcome can be generalized.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"596013"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Challenges in a Pediatric Case of Recurrent Blistering Skin Reactions: Ibuprofen-Induced Fixed Drug Exanthema versus Infection-Triggered Erythema Multiforme.","authors":"Ramona Möhrle, Irmgard Toni, Nicola Wagner, Stefan Schliep, André Hoerning, Antje Neubert","doi":"10.2147/DHPS.S584720","DOIUrl":"10.2147/DHPS.S584720","url":null,"abstract":"<p><p>A 12-year-old patient was hospitalized with suspected recurrent Stevens-Johnson syndrome (SJS) caused by ibuprofen. The patient presented with aphthous lesions on the lips and oral mucosa, accompanied by fever and cough. Further examination revealed more severe symptoms. The exact classification of his skin reaction and the underlying cause were challenging due to the coexistence of multiple potential triggers. The diagnostic overlap among various skin reactions requires careful evaluation of the clinical presentation and histopathological findings in relation to potential drug exposure and/or infectious triggers. Cutaneous reactions such as SJS and fixed drug exanthema are predominantly associated with drug exposure, whereas Erythema multiforme (EM) and <i>Mycoplasma pneumoniae</i> rash and mucositis (MIRM) are mainly linked to infectious triggers. The diagnosis of a skin reaction and its trigger is highly relevant for therapy and prevention of further episodes. In this patient, administration of ibuprofen, as well as infections with Herpes simplex virus (HSV) and <i>Mycoplasma pneumoniae</i> (M. pneumoniae) were considered potential triggers, highlighting the complexity of this case. The patient recovered following extensive therapy and was discharged after two weeks.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"584720"},"PeriodicalIF":4.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Types of Medical Errors Reporting Following the Implementation of Electronic Health Record System.","authors":"Ashraf A'aqoulah, Malak Alqahtani, Dalal F Bin Dayel, Bandar Zarbah, Farah Kalmey, Ghassan Shattat, Raghib Abusaris","doi":"10.2147/DHPS.S558973","DOIUrl":"10.2147/DHPS.S558973","url":null,"abstract":"<p><strong>Introduction: </strong>Constant supervision is required in a hospital setting because medication errors are a common occurrence and can be potentially harmful to patients.</p><p><strong>Objective: </strong>To examine patterns in medication error rates, types, and departmental distributions at tertiary hospitals from 2013 to 2023.</p><p><strong>Methods: </strong>In this cross-sectional research, the internal hospital medication error database was utilized, collecting data on dosage errors which included Wrong Dose, Drug Omission, Timing Error, and the departments assignment of errors include ICU, General Ward, Pharmacy, Emergency Department for a continuous duration of 11 years.</p><p><strong>Results: </strong>The reports for medication errors at tertiary hospitals for the years 2013-2023 altogether displayed fairly consistent behavior. Maximum error count was in the year 2019 with 6108 errors while the minimum was in the year 2015 with errors summing up to 725. The results showed fallen in medication errors to 1279 errors by 2023. Important types of errors were wrong/unclear dose prescriptions that used to peak in 2019 with 1307 and also duplication of medication errors increased with 297 additional errors between 2013 to 2023. The changes between types of errors made (χ² = 1297.75, p-value < 0.001), hospital centers (χ² = 1668.97, p-value < 0.001) and sections of the hospital in which they were carried out (χ² = 3086.19, p-value < 0.001) proved vital through chi-square tests done and thus showcasing the shifting control of medication error detection and reporting brought by electronic health record (EHRs) system and training.</p><p><strong>Conclusion: </strong>Medication errors showed variability with peaks, troughs, and fluctuations, demonstrating the inter-year coping mechanisms of EHRs system and personnel. Decision makers need to improve the system alongside staff education and some focused departmental attention. Although there has been some improvement in reporting errors, reporting new emerging errors, such as duplication of procedures, necessitates further vigilance in the dispensation of services to patients.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"558973"},"PeriodicalIF":4.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend of Reported Bleeding in Warfarin Compared with Direct Oral Anticoagulants in Japan.","authors":"Akina Takami, Gen Terashima, Takumi Tajima, Koki Yamashita, Ataru Igarashi","doi":"10.2147/DHPS.S601538","DOIUrl":"10.2147/DHPS.S601538","url":null,"abstract":"<p><strong>Background: </strong>Evidence on bleeding events associated with oral anticoagulants in real-world settings is limited. Thus, we compared the incidence rate of oral anticoagulant-associated bleeding between warfarin and direct oral anticoagulants (DOACs).</p><p><strong>Methods: </strong>This is a retrospective observational study using the Japanese Adverse Drug Event Report Database (JADER) and the nationwide health insurance claims database. We investigated the number of case reports with \"bleeding\" or \"hemorrhage\" using the JADER. The drugs of interest included warfarin, dabigatran, edoxaban, rivaroxaban, or apixaban. Main outcome measures included the number of case reports of bleeding and the estimated annual incidence rate of oral anticoagulant-associated bleeding using the Japanese Adverse Drug Event Report (JADER) and the nationwide estimated number of patients with prescriptions.</p><p><strong>Results: </strong>In JADER, we found 16,125 oral anticoagulant-associated bleeding in 15,970 case reports of patients between April 1, 2004, and March 31, 2024. The most common suspected oral anticoagulant administered to patients was apixaban (33.4%), followed by rivaroxaban (26.0%), warfarin (16.6%), edoxaban (13.3%), and dabigatran (10.7%). The incidence rates of anticoagulant-associated bleeding in patients who were prescribed dabigatran, edoxaban, rivaroxaban, and apixaban were higher compared to those in patients who were prescribed warfarin. The estimated annual incidence rate was remarkably high in patients who received apixaban, reaching 1976.90 per 1,000,000 patients.</p><p><strong>Conclusion: </strong>Compared with warfarin, the incidence rates of oral anticoagulant-associated bleeding were higher with dabigatran, edoxaban, rivaroxaban, or apixaban. In a real-world setting in Japan, the risk of oral anticoagulant-associated bleeding appears to be higher with DOACs than with warfarin.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"601538"},"PeriodicalIF":4.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13049600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Safety and Effectiveness of Calcium Channel Blockers in Hypertension: A Systematic Review.","authors":"Nur Aisyah, Jihan Sadira Aurellia, Widya Norma Insani","doi":"10.2147/DHPS.S576249","DOIUrl":"10.2147/DHPS.S576249","url":null,"abstract":"<p><strong>Purpose: </strong>Calcium channel blockers (CCBs) are widely used as first-line therapy for hypertension, but concerns remain regarding their long-term safety and effectiveness. This review aims to systematically summarize the existing evidence on the long-term safety and effectiveness of CCBs in patients with hypertension.</p><p><strong>Methods: </strong>A systematic review was conducted using the PubMed database to identify randomized controlled trials (RCTs), cohort studies, and case-control studies assessing the long-term use (≥1 year) of CCBs in adult hypertensive populations. Eligible studies compared CCBs with other antihypertensive agents or placebo and reported outcomes related to systemic safety and effectiveness. The quality of each study was assessed using the Jadad and Newcastle-Ottawa Scales. Evidence was synthesized descriptively and stratified by organ system and clinical outcome.</p><p><strong>Results: </strong>In total, 29 studies met the inclusion criteria, encompassing both RCTs and observational studies. Long-term CCB use was generally safe, with manageable risks. Renal protective effects were less consistent, while several studies reported a marginal increase in the incidence of new-onset diabetes. Associations with breast cancer remained inconclusive, and the risk of bone fractures appeared modestly reduced. Other systemic effects, including metabolic and reproductive changes, were generally mild. In terms of effectiveness, CCBs consistently reduced stroke incidence, although evidence regarding other cardiovascular outcomes, such as infarction, heart failure, and transient ischemic events, was inconsistent across studies.</p><p><strong>Conclusion: </strong>Overall, CCBs are safe for long-term use and show sustained effectiveness in stroke and angina, although evidence for heart failure, myocardial infarction, and transient ischemic attack remains inconsistent.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":"18 ","pages":"576249"},"PeriodicalIF":4.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}