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Arrhythmogenic right ventricular dysplasia (ARVD) and Brugada syndrome( BS) are associated with an increased risk of sudden cardiac death. Although they are described as two different entities, research suggests that they are not entirely separate. This paper presents a 55 years old male who presented for syncope. Interestingly, his electrocardiogram met the diagnostic criteria for both ARVD and BS. Subsequently, an implantable cardioverter-defibrillator (ICD) was implanted before discharge due to his high risk of sudden cardiac death. This case revealed that ARVD and BS clinical features can coexist in a single patient, and therefore supports the existence of a common pathophysiological basis of both diseases.Marijuana is one of the most popular psychotropic drugs among adolescents and young adults. With the recent surge in marijuana use across the United States, it is very important for physicians to understand the clinical implications associated with marijuana use. In this case report, we discuss a case of a young adult who presented to the emergency department with chest pain and was found to have three-vessel coronary artery disease (CAD). The patient did not have any significant past medical history or family history of cardiac diseases but reported a significant history of marijuana use. This case report aims to add to the growing area of research on the association between myocardial infarction (MI) and marijuana use.Encephalitis is one of the rare complications of coronavirus disease 2019 (COVID-19) that can be missed and confused with other causes of encephalitis. There was a 36-year-old male known to have glucose-6 phosphate dehydrogenase deficiency, who was brought to the emergency department with fever and confusion of one-week duration. Altered mental status work-up, including cerebrospinal fluid analysis, was done and turned out to be nondiagnostic. Multiple prolonged video-electroencephalographic recordings were done and showed different abnormalities suggestive of encephalitis. The diagnosis of COVID-19-induced encephalitis was made by exclusion of other encephalitis-related etiologies in the presence of a positive COVID-19 polymerase chain reaction (PCR) test, and treatment was initiated accordingly. Over a period of three weeks, the patient showed progressive improvement and was discharged home with regular follow-up in the neurology clinic. Upon follow-up in the clinic, the patient was fully independent but with multiple abnormal electroencephalographic recordings showing generalized encephalopathy with no epileptic discharges.Aquagenic wrinkling of the palms (AWP), also known as aquagenic palmoplantar keratoderma, is an uncommon dermatosis characterized by transient translucent whitish papules, edema, and hyper-wrinkling of the palms and soles shortly after water immersion. Approximately up to 80% of cases reported are associated with cystic fibrosis (CF) patients and up to 25% with CF carriers. We present the case of a 16-year-old male who complains of new-onset symmetrical edematous wrinkling on his palms associated with brief water exposure. After evaluation and genetic testing, the patient was diagnosed with CF and AWP. While there are numerous theories regarding the pathogenesis of AWP, no consensus has been reached regarding its etiology or relationship with CF. However, given the high prevalence of AWP associated with the genetic disease, physicians should have a high index of suspicion of CF or cystic fibrosis transmembrane regulator (CFTR)-related disease in pediatric patients with this presentation. The presence of AWP as part of the physical examination may help recognize challenging CF cases with uncommon genetic variants. Prompt recognition of CF disease leads to timely initiation of CFTR-modulating therapy, improving the patient's health outcomes and quality of life. In this case, we also present the patient's response to CFTR-modulating therapy and compare with baseline status.

This case report details the influence of media on patients and the responsibility of health care providers to educate their patients on proper use of medications, and to be aware of potential misadventures based on messages in popular media.

The sudden rise of the COVID19 pandemic has led to media outlets reporting science without necessary peer review and has resulted in preliminary data presented as factual evidence. It is difficult for patients without an extensive medical background in science to fully understand the uncertainty of information shared in popular media. This was demonstrated when preliminary data showed potential promise of hydroxychloroquine for the treatment/prevention of COVID19. This led to patients requesting hydroxychloroquine prescriptions from their providers, as well as stockpiling medication, which led to a shortage. In addition, patients began taking chloroquine containing substances not intended for human consumption. Popular media created a belief in the general public thaarm caused by misinformation from unreliable media sources.

The media provides a significant portion of the information that patients receive regarding rapidly changing treatment information in a pandemic. It is crucial for health care providers to know what information patients are exposed to, and to educate patients with evidence-based information. Pharmacists are the most accessible health care providers and have a key role in medication review and management. Educating patients on evidence-based use of medications may help avoid harm caused by misinformation from unreliable media sources.

The study purpose was to critically review FDA-issued warning letters (WLs) and notice of violation (NOV) letters against drug companies' from 2012-2019 for economic, clinical, and humanistic (ECHO) claims made in pharmaceutical promotional materials. Specific objectives were to assess the, (1) number of WLs and NOV issued; (2) frequency of WLs and NOV by therapeutic areas; (3) type of communication media cited in WLs or NOV; (4) intended audience for the claims in promotional materials for which the WLs and NOV were issued; and (5) number of WLs and NOV for ECHO claims.

The quantitative content analysis approach was employed to review WLs and NOVs, obtained from the FDA website, from January 2012-December 2019. A data abstraction form was created based on the published literature on this topic and assessment of the content of WLs and NOVs for 2010. This form was pilot tested on letters issued in 2011. The researchers discussed any unclear question or information presented in the letters. The letters wereuded in the promotional materials targeted to consumers as well as healthcare providers. selleck inhibitor Promoting reliable, evidence-based information is important for the health of the public as inadequate information could lead to irrational decision making both on consumer as well as on prescriber side.

The study found misleading claims of the clinical effectiveness and risk information included in the promotional materials targeted to consumers as well as healthcare providers. Promoting reliable, evidence-based information is important for the health of the public as inadequate information could lead to irrational decision making both on consumer as well as on prescriber side.

When available, empirical evidence should help guide decision-making. Following each administration of a learning assessment, data becomes available for analysis. For learning assessments, Kane's Framework for Validation can helpfully categorize evidence by inference (i.e., scoring, generalization, extrapolation, implications). Especially for test-scores used within a high-stakes setting, generalization evidence is critical. While reporting Cronbach's alpha, inter-rater reliability, and other reliability coefficients for a single measurement error are somewhat common in pharmacy education, dealing with multiple concurrent sources of measurement error within complex learning assessments is not. Performance-based assessments (e.g., OSCEs) that use raters, are inherently complex learning assessments.

Generalizability Theory (G-Theory) can account for multiple sources of measurement error. G-Theory is a powerful tool that can provide a composite reliability (i.e., generalization evidence) for more complex leat demonstrate use of G-Theory in pharmacy education.

Community pharmacists increasingly contribute to medication risk management while dispensing medicines to outpatients. Their risk management actions are shifting from medication counselling towards reviewing medications and following-up their therapeutic effects and outcomes. Acquiring these more clinical tasks require more patient care-oriented competences.

To identify gaps in community pharmacists' competence in medication risk management in routine dispensing.

All community pharmacies in Finland.

A national cross-sectional online survey was conducted through the Association of Finnish Pharmacies (n=574 community pharmacies) and the university pharmacies (n=2) in 2015. One pharmacist from each pharmacy was recommended to report on behalf of their outlet.

Community pharmacists' self-assessed competence to 1) identify medication-related risks, 2) utilise electronic tools in medication risk management, and 3) identify their perceived needs for developing competence in medication risk management.

Res' current competence in medication risk management, particularly in their competence in applied and geriatric pharmacotherapy.

The results indicate remarkable gaps in community pharmacists' current competence in medication risk management, particularly in their competence in applied and geriatric pharmacotherapy.

Reliability is critical validation evidence on which to base high-stakes decision-making. Many times, one exam in a didactic course may not be acceptably reliable on its own. But how much might multiple exams add when combined together?

To improve validation evidence towards high-stakes decision-making, Generalizability Theory (G-Theory) can combine reliabilities from multiple exams into one composite-reliability (G_String IV software). Further, G-Theory decision-studies can illustrate changes in course-grade reliability, depending on the number of exams and exam-items.

101 first-year PharmD students took two midterm-exams and one final-exam in a pharmaceutics course. Individually, Exam1 had 50MCQ (KR-20=0.69), Exam2 had 43MCQ (KR-20=0.65), and Exam3 had 67MCQ (KR-20=0.67). After combining exam occasions using G-Theory, the composite-reliability was 0.71 for overall course-grades-better than any exam alone. Remarkably, increased numbers of exam occasions showed fewer items per exam were needed, and fewesions for educators is developing fewer items per exam and fewer items over all exams.

Obtaining patient medication histories during emergency department (ED) admissions is an important step towards identifying potential errors that could otherwise remain in the patient's active medication list. This is a descriptive report of a standardized, electronic data collection tool created to document potential medication errors in patients receiving high-risk medications during ED admissions.

Trained pharmacy technicians completed a survey following medication history collection using a secure web platform called REDCap®. Data collected included patient-specific information, the number and type of high-risk medications, and potential medication errors identified in the collection process.

During a pilot period of April 2019 to October 2020, 191 patient records were completed using the survey tool. Out of a total of 1088 medications recorded, 41% were considered high-risk medications. 42% of potential medication errors were classified as high-risk medication errors. Results from this survey tool demonstrated that 58% of high-risk medication orders could potentially result in a medication error that can be carried through patient admission and discharge.