International Journal of Risk & Safety in Medicine - Volume 1, issue 2

Authors: de Jong-van den Berg, L.T.W. | van den Berg, P.B. | Peters, P.W.J. | Haaijer-Ruskamp, F.M.

Article Type: Research Article

Abstract: The prescription records of 1948 Dutch women who delivered a live-born infant during an 18 month period in 1987 and 1988 were set against the Australian classification of drugs with respect to the known or suspected risks in pregnancy. During pregnancy the use of drugs with proven or anticipated foetal toxicity proves to decrease, indicating that the medical profession is relatively well aware of these potential side effects. In the case of antibiotics the fall in the use of potentially toxic drugs is due to a shift to relatively less toxic drugs whereas the decreased use of analgesics and some …antirheumatic drugs is not accompanied by replacement by others. Prescriptions for hormonal contraceptives were sometimes actually filled in the first trimester of pregnancy, and the figures suggest that exposure to these products in early pregnancy may not be negligible. The present study shows that in spite of the generally favourable trends, 167.8 out of 1000 women received during the course of pregnancy one or more prescriptions from the higher risk categories (D, C or B3) in the Australian system. By combining such utilization studies with data from registries of birth defects one will be able to develop the fund of knowledge and to ensure that the classification of drugs with respect to their risks in pregnancy is as accurate as it can reasonably be. Show more

Keywords: Drug utilization, Teratogenicity, Risk classification system, Pregnancy, Prenatal care

DOI: 10.3233/JRS-1990-1201

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 91-105, 1990

Authors: Bergenheim, A. Tommy | Henriksson, R. | Knibestöl, M.

Article Type: Research Article

Abstract: The health professional caring for the unconscious patient is inclined to assume that it will be pointless to attempt to communicate with him or her. There are however valid reasons to talk to the unconscious individual. On the one hand it is a sign of respect and proper care and concern towards both the patient and the family. On the other hand evidence exists in various forms that speech can affect physiological function even in the unconscious and that in some instances there is even a potential for cortical response. Although one cannot know to what extent an unconscious patient …experiences the voice, it has been suggested that talking to the unconscious patient could favourably affect the recovery process. Show more

Keywords: Patient care, Unconsciousness, Speech, Communication

DOI: 10.3233/JRS-1990-1202

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 107-112, 1990

Authors: Barratt, C.L.R. | Cook, I.D.

Article Type: Review Article

Keywords: Donor semen, Pathogen, Transmission, Screening

DOI: 10.3233/JRS-1990-1203

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 113-115, 1990

Authors: James, Catherine E.

Article Type: Other

DOI: 10.3233/JRS-1990-1204

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 117-121, 1990

Authors: van Gruting, C.W.D.

Article Type: Review Article

Abstract: In much of the world, public health policy regarding medical devices and the need to ensure their safety is poorly defined and much less developed than that regarding pharmaceuticals. A small number of countries have now established systems to monitor risk and to ensure some form of assessment and approval of medical equipment, at least where an element of risk could be involved. In view of the very large number of medical devices and current evidence of their unwanted effects there is a reason for the extension of such monitoring and licensing systems, complemented by self-regulatory mechanisms. Measures are also …needed to ensure that when they enter the field devices are properly used and maintained. In various respects, the close analogy of pharmaceutical regulation can be applied. Show more

Keywords: Medical device, Safety, Epidemiology of risk, Regulation, Pharmaceutical law

DOI: 10.3233/JRS-1990-1205

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 123-133, 1990

Authors: Svane, S.

Article Type: Research Article

Abstract: Two patients developed superior vena cava syndrome following total parenteral nutrition through a central venous catheter. Infection may have contributed to the development of the thromboses. In one patient a “sleeve thrombus” probably fragmented when the catheter was withdrawn, leading to multiple pulmonary embolisms. The other patient had a mural thrombosis with complete occlusion of the superior vena cava. In view of the potentially high mortality of this serious complication, early diagnosis and treatment are essential.

Keywords: Total parenteral nutrition, Thrombosis, Superior vena cava syndrome

DOI: 10.3233/JRS-1990-1206

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 135-140, 1990

Authors: Naess, F. | Nesbakken, A. | Solheim, K. | Pillgram-Larsen, J. | Gerner, T. | Stadaas, J.O.

Article Type: Research Article

Abstract: Abdominal organ injuries caused by blunt trauma are notoriously difficult to diagnose and a vital operation may as a result be dangerously delayed. In a series of 331 patients admitted after blunt abdominal trauma, 426 abdominal organ injuries were registered. 152 of these patients had 199 abdominal organ injuries requiring surgical repair. In 31 of these patients (20%) with 44 organ injuries operation was delayed for more than 6 hours after admission, in most instances because the diagnosis had been missed. One of these patients died as a consequence. Hollow organ injuries were the most commonly missed. Peritoneal lavage, repeated …if necessary, and diagnostic imaging must be used as valuable tools in addition to repeated clinical evaluation, especially in comatose patients, in patients with multiple injuries, and in intoxicated patients. Show more

Keywords: Blunt trauma, Missed diagnosis, Delayed treatment, Laparotomy

DOI: 10.3233/JRS-1990-1207

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 141-147, 1990

Article Type: Other

DOI: 10.3233/JRS-1990-1208

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 149-150, 1990

Authors: Bennett, P.N. | Faccini, I.M.

Article Type: Other

DOI: 10.3233/JRS-1990-1209

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 151-152, 1990

Authors: von Wartburg, W.P.

Article Type: Other

DOI: 10.3233/JRS-1990-1210

Citation: International Journal of Risk and Safety in Medicine, vol. 1, no. 2, pp. 153-156, 1990