The International journal of risk & safety in medicine最新文献_第7页

The digital profile of a physician as a new approach to improving recommendation systems for prescribing drugs. 医生的数字档案是改进处方推荐系统的新方法。

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The International journal of risk & safety in medicine Pub Date : 2026-05-01 Epub Date: 2025-11-12 DOI: 10.1177/09246479251389215

Alexander A Kondrashov, Ekaterina E Loskutova, Maxim M Kurashov

{"title":"The digital profile of a physician as a new approach to improving recommendation systems for prescribing drugs.","authors":"Alexander A Kondrashov, Ekaterina E Loskutova, Maxim M Kurashov","doi":"10.1177/09246479251389215","DOIUrl":"10.1177/09246479251389215","url":null,"abstract":"IntroductionArtificial intelligence (AI) is increasingly integral to healthcare's digital transformation, enhancing areas such as disease prevention and control. Traditional AI models focus on patient-centered data from electronic medical records (EMRs). This study aims to improve drug prescription recommendation systems by developing a physician's digital profile (DP), incorporating physician characteristics into machine learning models.MethodsVisit-level EMR clinical data (2018-2023) of Moscow's children's polyclinics was collected and contained information on 174,806 appointments with 30 physicians and 53,453 patients. We developed multi-output regression models (LGBMRegressor) using gradient boosting algorithms. Models were trained with and without the physician's DP, which included personal, drug, and nosological features adapted for machine learning.ResultsIncorporating the physician's digital profile significantly improved model performance. The LGBMRegressor with DP reduced the average RMSE from 4.20 to 0.74. Models utilizing the DP more accurately predicted drug prescriptions and better captured individual physician behaviors.DiscussionDeveloping a physician's digital profile has been shown to enhance the predictive performance of machine learning models in drug prescribing. This approach supports the optimization of clinical decision support systems, fostering more safe and personalized care and potentially reducing prescribing errors. Moreover, aggregated model outputs may inform drug demand forecasting and assist in optimizing pharmaceutical inventory planning at the population level.","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"185-192"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk factors associated with anti-tubercular therapy-induced hepatitis in human immunodeficiency virus seropositive and seronegative patients in India. 印度人类免疫缺陷病毒血清阳性和血清阴性患者抗结核治疗性肝炎的相关危险因素

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-11-24 DOI: 10.1177/09246479251401359

Aneez Jamal Km, Ashutosh Bhosale, Muralidhar Varma, Rajesh Radhakrishnan

{"title":"Risk factors associated with anti-tubercular therapy-induced hepatitis in human immunodeficiency virus seropositive and seronegative patients in India.","authors":"Aneez Jamal Km, Ashutosh Bhosale, Muralidhar Varma, Rajesh Radhakrishnan","doi":"10.1177/09246479251401359","DOIUrl":"10.1177/09246479251401359","url":null,"abstract":"BackgroundPeople living with Human Immunodeficiency Virus (PLW-HIV) on anti-retroviral therapy are more likely to develop tuberculosis as compared to people without HIV. The objective of the study is to evaluate the risk factors, prevalence, and management pattern of Anti-tubercular therapy-induced hepatitis (ATT-IH) in PLW-HIV with Anti-Retroviral Therapy (ART) in comparison with HIV-SNP.MethodologyA retrospective observational cohort study was conducted at a university teaching hospital for Anti-tubercular therapy-induced hepatitis ATT-IH. Patients were screened based on International Classification of Diseases codes 10. A total of N = 431 patients with ATT-IH (250 males and 181 females) were included in the study. The severity grading of ATT-IH was assessed by Liver Tox. The risk factors associated with ATT-IH in HIV-SPP and HIV-SNP were assessed and determined at a p value <0.05.ResultsOut of 431 patients with ATT-IH, 231 patients experienced ATT-IH in the HIV-SP group and 200 patients in the HIV-SN group. Zero-inflated regression analysis identified risk factors for ATT-IH in HIV-SPP in comparison with HIV-SNP, including BMI, hepatitis B, and smoking habits. The prevalence of ATT-IH in HIV-SPP was 53.6% and 46.4% in HIV-SNP. A higher incidence of 23 (10 %) of ATT-IH was reported with the Tenofovir + Lamivudine + Lopinavir+ Ritonavir ART regimen.ConclusionClinicians must focus on early detection of risk factors for ATT-IH in HIV-SPP in comparison with HIV-SNP to prevent significant hepatic complications.","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"131-143"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nifedipine and mycophenolate mofetil-induced gingival hyperplasia in a patient with systemic sclerosis: Role of concomitant therapy and pharmacovigilance aspects. 硝苯地平和霉酚酸酯诱发的系统性硬化症患者的牙龈增生：伴随治疗和药物警戒方面的作用。

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-11-05 DOI: 10.1177/09246479251389217

Shreya K Gowda, Bevan Priyadarshan, Biswanath Behera, Vishal Thakur

{"title":"Nifedipine and mycophenolate mofetil-induced gingival hyperplasia in a patient with systemic sclerosis: Role of concomitant therapy and pharmacovigilance aspects.","authors":"Shreya K Gowda, Bevan Priyadarshan, Biswanath Behera, Vishal Thakur","doi":"10.1177/09246479251389217","DOIUrl":"10.1177/09246479251389217","url":null,"abstract":"BackgroundDrug-induced gingival overgrowth (DIGO) is a common adverse effect of anticonvulsants, calcium channel blockers (CCBs), and immunosuppressants like cyclosporine, with nifedipine being the most frequently implicated CCB. In contrast, mycophenolate mofetil (MMF)-induced DIGO is rare due to its antifibrotic properties.Case reportWe report a case of a 26-year-old female with systemic sclerosis (SSc), receiving nifedipine and MMF for Raynaud's phenomenon and interstitial lung disease, who presented with grade I gingival hyperplasia confined to interdental papillae. Despite good oral hygiene, gingival inflammation, microstomia, and plaque accumulation contributed to DIGO. Nifedipine was substituted with tadalafil, and MMF was replaced with nintedanib due to worsening interstitial lung disease. The pathogenesis of DIGO involves TGF-β-mediated fibroblast proliferation and extracellular matrix deposition, mechanisms also implicated in SSc-related fibrosis. Genetic polymorphisms in TGF-β and fibroblast regulatory genes further increase susceptibility. Effective management includes drug substitution, meticulous oral hygiene, and surgical excision for persistent cases.ConclusionThis report highlights the need for vigilant pharmacovigilance in SSc patients, emphasizing early detection, genetic risk assessment, and preventive dental care to mitigate DIGO progression. Personalized risk stratification based on genetic profiling may enhance DIGO prevention and therapeutic strategies in high-risk individuals.","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"144-147"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145447020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dimensions of medical errors - The three victims and defensive medicine. 医疗差错的维度——三个受害者和防御性医学。

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-09-30 DOI: 10.1177/09246479251372341

Mohamed Abosheisha, Islam Omar

{"title":"Dimensions of medical errors - The three victims and defensive medicine.","authors":"Mohamed Abosheisha, Islam Omar","doi":"10.1177/09246479251372341","DOIUrl":"10.1177/09246479251372341","url":null,"abstract":"BackgroundDespite recent advances in medical sciences, the utilisation of technology, and the spread of awareness on patient safety, medical errors still occur and impose a significant burden on healthcare facilities and society. Safety incidents have an impact on the doctor-patient relationship, leading to a defensive medical practice.ObjectiveThis narrative review aims to present an overview of the dimensions of medical errors and their consequences, with a focus on the second victim phenomenon and defensive medicine.MethodsSearch of the PubMed-indexed relevant publications in the English language. The full texts of the relevant publications have been summarised.ResultsThis review explored the dimensions of medical errors and their consequences. The second victim phenomenon describes the physical symptoms and emotional experience of the healthcare practitioners involved in safety incidents. There is a limited number of structured support programs to help the second victims. Unfair media coverage of medical errors adds pressure and directs the blame rather than contributing to solving the problem. Defensive medicine originated due to the increasing litigation claims and represents a fundamental change in the doctor-patient relationship. It takes two forms: positive and negative defensive medicine.ConclusionsThis multidimensional presentation of the topic may be helpful to readers involved in such incidents or working to mitigate their consequences. Patients should understand they are not the only victims of the harm imposed on them. The staff involved should seek help, and healthcare facilities should offer support programs for staff involved in safety incidents. The general audience should receive the published material about medical errors in a reasonably neutral manner and avoid one-sided presentations in the media.","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"23-30"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Author's response: Rates of successful conceptions according to COVID-19 vaccination status: Data from the Czech Republic. 提交人的答复：根据COVID-19疫苗接种状况确定的受孕成功率：来自捷克共和国的数据。

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-09-09 DOI: 10.1177/09246479251378936

Vibeke Manniche, Tomáš Fürst, Max Schmeling, Jonathan D Gilthorpe, Peter Riis Hansen

引用次数: 0

Rectal shedding of SARS-CoV-2 in patients with negative COVID-19 nasopharyngeal RT-PCR test. 2019冠状病毒病鼻咽RT-PCR阴性患者- cov -2直肠脱落的研究

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-11-01 DOI: 10.1177/09246479251394918

Svetlana Doris Brincat, Matthew Sammut, Neville Spiteri, Graziella Zahra, Christopher Barbara, Victor Grech, Jo-Etienne Abela, Charles Cini

{"title":"Rectal shedding of SARS-CoV-2 in patients with negative COVID-19 nasopharyngeal RT-PCR test.","authors":"Svetlana Doris Brincat, Matthew Sammut, Neville Spiteri, Graziella Zahra, Christopher Barbara, Victor Grech, Jo-Etienne Abela, Charles Cini","doi":"10.1177/09246479251394918","DOIUrl":"10.1177/09246479251394918","url":null,"abstract":"BackgroundCOVID-19, caused by the novel coronavirus SARS-CoV-2, was first identified in China in December 2019 and rapidly spread worldwide, primarily affecting the respiratory system. Although RT-PCR on nasopharyngeal swabs is the standard diagnostic method, emerging evidence suggests that SARS-CoV-2 RNA may be detected in rectal swabs even if respiratory samples test negative.ObjectiveTo assess the ability of rectal swabs to detect SARS-CoV-2 viral shedding in participants with negative nasopharyngeal swabs.MethodAdult patients scheduled for colonoscopy at Mater Dei Hospital between June 2020 and April 2021 were enrolled. All participants had a confirmed negative nasopharyngeal swab for SARS-CoV-2 by RT-PCR within 72 h before enrolment and provided informed consent. Data on demographics, epidemiology and clinical symptoms were collected through structured interviews and medical record reviews. Prior to colonoscopy, rectal swabs were obtained and all samples were processed following standardised laboratory protocols.Results200 participants were enrolled. None of the patients had prior COVID-19 history. 7.5% (n = 15) tested positive on rectal swabs despite having a negative nasopharyngeal swab in the preceding 72 h.ConclusionWhile combining nasopharyngeal and rectal swab sampling may improve COVID-19 diagnosis, routine use of both methods might not be cost-effective. Nonetheless, rectal swabs could prove beneficial for symptomatic patients with negative nasopharyngeal results or those with known exposure to COVID-19.","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"114-119"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful management of therapy-resistant chronic refractory atopic dermatitis and alopecia universalis with oral tofacitinib in a girl. 口服托法替尼成功治疗难治性慢性难治性特应性皮炎和普遍脱发1例。

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-10-18 DOI: 10.1177/09246479251391089

Shreya K Gowda, Bhini Ameta, Akash Agarwal, Biswanath Behera

引用次数: 0

Safety analysis of adverse events associated with high-flow nasal cannula therapy: A retrospective study using Japan's national adverse event database. 高流量鼻插管治疗相关不良事件的安全性分析：一项使用日本国家不良事件数据库的回顾性研究。

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-10-16 DOI: 10.1177/09246479251389210

Keizo Wauchi, Sho Tomisaki, Hirohito Imada

{"title":"Safety analysis of adverse events associated with high-flow nasal cannula therapy: A retrospective study using Japan's national adverse event database.","authors":"Keizo Wauchi, Sho Tomisaki, Hirohito Imada","doi":"10.1177/09246479251389210","DOIUrl":"10.1177/09246479251389210","url":null,"abstract":"ObjectiveThis study aimed to extract incident and accident reports associated with high-flow nasal cannula (HFNC) therapy from the publicly available database maintained by the Japan Council for Quality Health Care (JCQHC) and to identify contributing factors using the P-mSHEL model (Patient-management-Software-Hardware-Environment-Liveware), with the goal of providing insights for improving HFNC safety.MethodsAmong 94,069 incident reports (defined as cases without patient harm) and 56,783 accident reports (cases with patient harm) submitted between 2010 and 2023, a total of 170 HFNC-related cases (131 incidents and 39 accidents) were identified. Quantitative variables included the time of occurrence, patient demographics, and involvement of healthcare professionals. Qualitative data were classified into six categories (P, m, S, H, E, L) using the P-mSHEL model. For accident cases, the presence or absence of sequelae was analyzed using logistic regression.ResultsIn accident cases, the Patient (P) factor (odds ratio = 2.65, p = 0.006) and the Management (m) factor (odds ratio = 2.46, p = 0.033) were significantly associated with the occurrence of sequelae. In incident cases, the Liveware (L) factor (i.e., human error) was involved in 80.2% of reports, and the Hardware (H) factor (i.e., medical devices) in 52.7%, highlighting the critical roles of human and device-related factors.ConclusionTo ensure the safe use of HFNC, it is essential to implement risk mitigation strategies targeting the Patient and Management factors, such as comprehensive patient screening and strengthened organizational systems. Furthermore, given the high involvement of the Liveware and Hardware factors, structured educational programs and practical interventions for medical device operation are warranted.","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"95-105"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Audit of referrals of patients on oral antithrombotic therapy to a hospital oral surgery service for simple tooth extractions. 对因简单拔牙而接受口腔抗栓治疗的患者转介到医院口腔外科服务的审计。

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-10-15 DOI: 10.1177/09246479251389205

Lea Vuletić, Monika Burja Vladić, Ivan Salarić, Ena Zdunić, Berislav Perić

{"title":"Audit of referrals of patients on oral antithrombotic therapy to a hospital oral surgery service for simple tooth extractions.","authors":"Lea Vuletić, Monika Burja Vladić, Ivan Salarić, Ena Zdunić, Berislav Perić","doi":"10.1177/09246479251389205","DOIUrl":"10.1177/09246479251389205","url":null,"abstract":"ObjectiveTo assess the proportion of patients referred to a hospital oral surgery department for procedures that could have been managed in primary care.MethodThis cross-sectional audit included 41 outpatients on oral antithrombotic therapy who were referred to the University Hospital Dubrava in Zagreb, Croatia, for simple tooth extraction(s). Information about additional factors that may affect the complexity of the intervention was collected using a questionnaire. Any instructions regarding patients' antithrombotic therapy regimens were also recorded. An oral surgeon evaluated whether each surgical procedure could have been safely performed in primary care.ResultsThe oral surgeon estimated that in 75.6% (31/41) of the cases, the indicated extractions could have been safely managed in primary care, provided the clinician had relevant training and confidence. Instructions to discontinue antithrombotic therapy prior to the procedure were frequently encountered and, in most cases, issued by the patients' dentists.ConclusionThe findings of this study support the need for more comprehensive studies on the quality, appropriateness and underlying reasons for referrals to oral surgery departments. Such research would provide evidence to guide the development and implementation of measures aimed to enhance dentists' clinical skills, self-confidence, and interdisciplinary collaboration, ultimately improving patient care.","PeriodicalId":520800,"journal":{"name":"The International journal of risk & safety in medicine","volume":" ","pages":"106-113"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient viewpoint: The case for exploring non-seizure alternatives to ECT. 患者观点：探索非癫痫发作替代ECT的案例。

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The International journal of risk & safety in medicine Pub Date : 2026-02-01 Epub Date: 2025-09-05 DOI: 10.1177/09246479251377340

Christopher James Dubey

引用次数: 0