African American ethnicity is a newly identified predictor of warfarin requirements >5 mg/d and is independent of dietary vitamin K intake. An assessment tool incorporating this and other predictors can estimate a patient's likelihood of requiring such dosages.

The Broselow tape is accurate for weight estimation in children < or =25 kg, but the Theron formula performs better with patients weighing >40 kg. The Broselow tape was not statistically superior to the Leffler formula in subjects weighing 25.1 to 40 kg. A separate cohort is needed to evaluate the validity of the alternative predictive formulae.

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Consistent with clinical trial data, alvimopan use resulted in an approximately 1 day shorter postoperative length of stay and was associated with substantial cost savings.

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Objective. To assess the effectiveness of a longitudinal evidence-based medicine (EBM) curriculum to improve pharmacy resident knowledge and skills in evidence-based practice as measured by the Fresno Test. Methods. Residency program director and clinical pharmacist preceptors in a community teaching hospital developed a longitudinal EBM curriculum for a postgraduate year one (PGY1) pharmacy practice residency. The program was offered as a yearlong series of 1-hour meetings to train residents in evidence-based practice. A pre/post study design was used to evaluate the program. The full 12-item Fresno Test was used to measure specific EBP skills: Ask, Acquire, Appraise, Apply and Assess. Pre/post composite and item mean scores were compared using Student's paired t-test. Results. Forty-three residents completed pre-and post-Fresno Test evaluations between 2008 and 2014 with a mean increase in pre-and post-training scores from 125.9 (SD 32.9) to 138.5 (SD 33.6), p5.02. Conclusion.A longitudinal training program in EBM in a pharmacy residency demonstrated improvement in core evidence-based practice abilities as measured by the Fresno Test.

The addition of scheduled tramadol in patients receiving concomitant morphine and ketorolac demonstrates a trend toward decreased morphine and polyethylene glycol use.

Studies have shown that the optimal time to give preoperative prophylactic antibiotics is within 2 hours prior to the incision. An initial study of perioperative antibiotic use at our institution revealed significant deficiencies both in the timing and the charting of preoperative antibiotics. In response to these findings, a multidisciplinary total quality management team was formed. This team identified several key problems related to the timing and documentation of preoperative antibiotics. Accordingly, our institution's method of prophylactic antibiotic delivery and administration was revised, and a program to educate appropriate staff was formulated. Following these interventions, a second study found that the number of preoperative antibiotic doses given at the proper time improved from 86% in the previous study to 98%, and that the number of doses properly charted improved from 84% to 94%.