This review highlights 5 key factors that contributed to the occurrence of CPOE-related medication errors in pediatrics. Dosing support is the most important. More advanced clinical decision support that can suggest doses based on the drug indication is needed.

No abstract

BackgroundSubclinical thyrotoxicosis (SCT) is associated with significant morbidity and mortality, specifically increased risk of atrial fibrillation and cardiovascular death. The management is ill-defined due to the scarcity of randomised controlled studies. Some clinicians recommend radioiodine (RAI) treatment however its long-term outcome is unknown. Therefore, further data is needed to provide robust evidence-based guidelines.MethodsA prospective, single-protocol analysis of the outcome of SCT patients (Grade 1; 0.1-0.4 mIU/L and Grade 2; <0.1 mIU/L) treated with mean dose of 427 MBq of I131, followed up for up to 18 years. Thyroid function tests were measured at 4-6 weeks, 3-, 6-, and 12-months post-RAI, and annually thereafter. Cure was defined as achieving a euthyroid/hypothyroid state.ResultsSeventy-eight patients with a median age of 68 years (range 36-84) and varying aetiology [55 toxic multinodular goitre (TMNG), 10 toxic nodule (TN) and 13 Graves’ disease (GD)] were followed up for a median period of 7.5 years (range 1-18). The cure rate was 100%. The rates of hypothyroidism in TMNG, TN and GD were 23.6%, 30% and 38.5% respectively. The median time to hypothyroidism was 6 and 12 months in GD and TMNG/TN respectively. No differences in outcome between Grade 1 versus Grade 2 were observed.ConclusionRAI using single mean dose of 427 MBq is effective and safe, irrespective of aetiology or grade of TSH suppression. GD patients become hypothyroid within the first year, whilst TMNG/TN for up to 9-years. Thus after 12 months of follow up, annual thyroid function monitoring is advised.

Described is thermal radiation detector conceived for possible deployment on GERD (Geostationary Earth Radiation Budget). It consists of a linear array of 256 elements, each 60 .tm square and separated by a 3-im gap. Each element is the active junction of a single-junction-pair zinc-antimonide/platinum thermopile. The reference junction is mounted on an isothermal substrate, and the active junction is thermally isolated from the substrate by a thin layer of parylene. The detector is mounted on one wall of a wedge-shaped, mirrored cavity intended to increase the effective absorptivity and improve the spectral flatness of the detector through multiple reflections. A dynamic opto-electrothermal model of the detector/cavity combination has been formulated in order to facilitate its optimal design. The optical part of the model is based on a Monte-Carlo ray trace that takes into account diffraction at the entrance slit as well as the diffuse and specular components of reflectivity of the cavity surfaces. Heat absorption and diffusion through the thermopile structure has been modeled using the finite element method. The model has been used to validate a method for eliminating optical cross-talk among elements of the array through postprocessing of data.