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Journal of Clinical Nursing Sep 2023Medication administration errors (MAEs) cause preventable patient harm and cost billions of dollars from already-strained healthcare budgets. An emerging factor... (Review)
Review
BACKGROUND
Medication administration errors (MAEs) cause preventable patient harm and cost billions of dollars from already-strained healthcare budgets. An emerging factor contributing to these errors is nurse fatigue. Given medication administration is the most frequent clinical task nurses undertake; it is vital to understand how fatigue impacts MAEs.
OBJECTIVE
Examine the evidence on the effect of fatigue on MAEs and near misses by registered nurses working in hospital settings.
METHOD
Arksey and O'Malley's scoping review framework was used to guide this review and PAGER framework for data extraction and analysis. The PRISMA checklist was completed. Four electronic databases were searched: CINAHL, PubMed, Scopus and PsycINFO. Eligibility criteria included primary peer review papers published in English Language with no date/time limiters applied. The search was completed in August 2021 and focussed on articles that included: (a) registered nurses in hospital settings, (b) MAEs, (c) measures of sleep, hours of work, or fatigue.
RESULTS
Thirty-eight studies were included in the review. 82% of the studies identified fatigue to be a contributing factor in MAEs and near misses (NMs). Fatigue is associated with reduced cognitive performance and lack of attention and vigilance. It is associated with poor nursing performance and decreased patient safety. Components of shift work, such as disruption to the circadian rhythm and overtime work, were identified as contributing factors. However, there was marked heterogeneity in strategies for measuring fatigue within the included studies.
RELEVANCE TO CLINICAL PRACTICE
Fatigue is a multidimensional concept that has the capacity to impact nurses' performance when engaged in medication administration. Nurses are susceptible to fatigue due to work characteristics such as nightwork, overtime and the requirement to perform cognitively demanding tasks. The mixed results found within this review indicate that larger scale studies are needed with particular emphasis on the impact of overtime work. Policy around safe working hours need to be re-evaluated and fatigue management systems put in place to ensure delivery of safe and quality patient care.
Topics: Humans; Pharmaceutical Preparations; Patient Safety; Hospitals; Fatigue; Menthol; Nurses
PubMed: 36707921
DOI: 10.1111/jocn.16620 -
European Journal of Applied Physiology Aug 2023Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19... (Review)
Review
Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19 pandemic has heightened attention on respiratory health and the means of enhancing it. Subsequently, and inevitably, the respiratory system has become a target of the multi-trillion-dollar health and wellness industry. Numerous commercial, respiratory-related interventions are now coupled to therapeutic and/or ergogenic claims that vary in their plausibility: from the reasonable to the absurd. Moreover, legitimate and illegitimate claims are often conflated in a wellness space that lacks regulation. The abundance of interventions, the range of potential therapeutic targets in the respiratory system, and the wealth of research that varies in quality, all confound the ability for health and exercise professionals to make informed risk-to-benefit assessments with their patients and clients. This review focuses on numerous commercial interventions that purport to improve respiratory health, including nasal dilators, nasal breathing, and systematized breathing interventions (such as pursed-lips breathing), respiratory muscle training, canned oxygen, nutritional supplements, and inhaled L-menthol. For each intervention we describe the premise, examine the plausibility, and systematically contrast commercial claims against the published literature. The overarching aim is to assist health and exercise professionals to distinguish science from pseudoscience and make pragmatic and safe risk-to-benefit decisions.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Pandemics; Pseudoscience; COVID-19; Breathing Exercises
PubMed: 36917254
DOI: 10.1007/s00421-023-05166-8 -
JAMA Jun 2024Chronic pruritus, defined as itch experienced for 6 weeks or longer, affects approximately 22% of people in their lifetime. Approximately 1% of physician visits are for... (Review)
Review
IMPORTANCE
Chronic pruritus, defined as itch experienced for 6 weeks or longer, affects approximately 22% of people in their lifetime. Approximately 1% of physician visits are for the chief concern of chronic pruritus. Chronic pruritus is associated with adverse outcomes, including impaired sleep and reduced quality of life.
OBSERVATIONS
Chronic pruritus can be categorized by etiology into inflammatory, neuropathic, or a combination of inflammatory and neuropathic pruritus. Chronic pruritus is due to inflammation in approximately 60% of patients and may be caused by eczema, psoriasis, or seborrheic dermatitis. Chronic pruritus is due to a neuropathic or mixed etiology in approximately 25% of patients. Neuropathic causes of chronic pruritus include postherpetic neuralgia and notalgia paresthetica and are typically due to localized or generalized nerve dysregulation. Approximately 15% of people with chronic pruritus have other causes including systemic diseases with secondary itch, such as uremic pruritus and cholestatic pruritus, medication-induced pruritus such as pruritus due to immunotherapy, and infectious etiologies such as tinea corporis and scabies. When few primary changes are present, a thorough history, review of symptoms, and laboratory evaluation should be performed, particularly for people with chronic pruritus lasting less than 1 year. Clinicians should consider the following tests: complete blood cell count, complete metabolic panel, and thyroid function testing to evaluate for hematologic malignancy, liver disease, kidney disease, or thyroid disease. First-line treatment for inflammatory chronic pruritus includes topical anti-inflammatory therapies such as hydrocortisone (2.5%), triamcinolone (0.1%), or tacrolimus ointment. Approximately 10% of patients do not respond to topical therapies. In these patients, referral to dermatology and systemic oral or injectable treatments such as dupilumab or methotrexate may be considered. When no underlying systemic disease associated with pruritus is identified, patients are likely to have neuropathic chronic pruritus or mixed etiology such as chronic pruritus of unknown origin. In these patients, neuropathic topical treatments such as menthol, pramoxine, or lidocaine can be used either alone or in combination with immunomodulatory agents such as topical steroids. Other effective therapies for neuropathic pruritus include gabapentin, antidepressants such as sertraline or doxepin, or opioid receptor agonist/antagonists such as naltrexone or butorphanol.
CONCLUSIONS AND RELEVANCE
Chronic pruritus can adversely affect quality of life and can be categorized into inflammatory, neuropathic, or a combined etiology. First-line therapies are topical steroids for inflammatory causes, such as hydrocortisone (2.5%) or triamcinolone (0.1%); topical neuropathic agents for neuropathic causes, such as menthol or pramoxine; and combinations of these therapies for mixed etiologies of chronic pruritus.
Topics: Humans; Pruritus; Chronic Disease
PubMed: 38809527
DOI: 10.1001/jama.2024.4899 -
The Journal of Allergy and Clinical... Jun 2024Nasal obstruction is the subjective perception and objective state of insufficient airflow through the nose. Nasal congestion, conversely, describes a state of not just... (Review)
Review
Nasal obstruction is the subjective perception and objective state of insufficient airflow through the nose. Nasal congestion, conversely, describes a state of not just inadequate airflow or obstructive phenomena but also pressure- and mucus-related states to the patient. Nasal receptors belonging to the transient receptor potential (TRP) protein family mediate the sense of nasal patency via the trigeminal nerve. The transient receptor potential melastatin-8 (TRPM8) responds to temperatures around 8°C to 22°C, and is stimulated by menthol and other cooling agents. The radiant effects of airflow create heat loss to activate these receptors and humans perceive this as nasal patency rather than the direct detection of airflow. The thermovascular state of the mucosa, in conditions such as rhinitis, influence TRPM8 activation. Nasal endoscopy can show signs of rhinitis and should be considered an essential part of the workup of nasal congestion. Efforts to relieve nasal congestion need to manage the mucosal state and surgery needs to ensures that the nasal cavity mucosa is exposed to the cooling effects of airflow rather than simply creating a passage to the nasopharynx.
Topics: Humans; Nasal Obstruction; Nasal Mucosa; TRPM Cation Channels; Endoscopy; Rhinitis
PubMed: 38677589
DOI: 10.1016/j.jaip.2024.04.028 -
Journal of Addictive Diseases 2023It has been hypothesized that menthol in cigarettes increases dependence. Several studies suggest that menthol and non-menthol smokers have similar or lower levels of...
BACKGROUND
It has been hypothesized that menthol in cigarettes increases dependence. Several studies suggest that menthol and non-menthol smokers have similar or lower levels of dependence, but those studies are not without limitations. The Heaviness of Smoking Index (HSI) is a widely accepted, validated measure of cigarette dependence.
OBJECTIVES
This report aims to provide further evidence regarding dependence among menthol and non-menthol smokers, as indicated by daily smoking and as measured by the HSI.
METHODS
Survey data from 27,131 adult smokers were analyzed to compare the percent of menthol and non-menthol smokers who are daily smokers, and the percentage who are low or high HSI dependence. Logistic regressions were also conducted to determine if menthol use predicts daily smoking, and low or high dependence after controlling for demographic differences.
RESULTS
Comparisons among weighted samples of adult smokers demonstrate that menthol smokers were consistently more likely to be non-daily smokers, more likely to be in the low dependence category, and less likely to be in the high dependence category on the HSI as compared to non-menthol smokers. Logistic regression confirmed that when controlling for age, gender, race/ethnicity, and education, relative to non-menthol smokers, menthol smokers had no difference in odds of being in the low dependence HSI category and significantly lower odds of being a daily smoker, and of being in the high dependence category.
CONCLUSIONS
These analyses support the conclusion that, based on the HSI, menthol smokers are not more cigarette dependent than non-menthol smokers, and may be dependent.
PubMed: 35993315
DOI: 10.1080/10550887.2022.2112495 -
Zhonghua Jie He He Hu Xi Za Zhi =... May 2024An elderly woman with a 1-year history of pulmonary shadows was admitted because of intermittent cough and sputum production for 2 months. Chest computed tomography (CT)...
An elderly woman with a 1-year history of pulmonary shadows was admitted because of intermittent cough and sputum production for 2 months. Chest computed tomography (CT) scans showed bilateral consolidations and ground-glass opacities, with areas of low attenuation inside consolidative opacities on the mediastinal window. Previous history of radiotherapy for nasopharyngeal carcinoma and long-term use of a compound menthol nasal drops provided were important clues to the diagnosis. CT scan-guided needle lung biopsy and bronchoalveolar lavage were performed, and lipid-laden macrophages were confirmed in both bronchoalveolar lavage and lung tissue. Final diagnosis of exogenous lipoid pneumonia was made on the basis of her risk factors for aspiration, history of oil exposure, and classic radiological and histopathological features. Symptoms improved after discontinuation of causative exposure. It is important for clinicians to raise awareness of exogenous lipoid pneumonia and other aspiration lung diseases.
Topics: Humans; Female; Aged; Pneumonia, Lipid; Tomography, X-Ray Computed; Lung
PubMed: 38706066
DOI: 10.3760/cma.j.cn112147-20231103-00290 -
Life Sciences Oct 2023Menthol is a small bioactive compound able to cause several physiological changes and has multiple molecular targets. Therefore, cellular response against menthol is...
Menthol is a small bioactive compound able to cause several physiological changes and has multiple molecular targets. Therefore, cellular response against menthol is complex, and still poorly understood. In this work, we used a human osteosarcoma cell line (Saos-2) and analysed the effect of menthol, especially in terms of cellular, subcellular and molecular aspects. We demonstrate that menthol causes increased mitochondrial Ca in a complex manner, which is mainly contributed by intracellular sources, including ER. Menthol also changes the Ca-load of individual mitochondrial particles in different conditions. Menthol increases ER-mito contact points, causes mitochondrial morphological changes, and increases mitochondrial ATP, cardiolipin, mitochondrial ROS and reduces mitochondrial membrane potential (ΔΨm). Menthol also prevents the mitochondrial quality damaged by sub-lethal and lethal doses of CCCP. In addition, menthol lowers the mitochondrial temperature within cell and also serves as a cooling agent for the isolated mitochondria in a cell free system too. Notably, menthol-induced reduction of mitochondrial temperature is observed in diverse types of cells, including neuronal, immune and cancer cells. As the higher mitochondrial temperature is a hallmark of several inflammatory, metabolic, disease and age-related disorders, we propose that menthol can serve as an active anti-aging compound against all these disorders. These findings may have relevance in case of several pharmacological and clinical applications of menthol. SIGNIFICANCE STATEMENT: Menthol is a plant-derived bioactive compound that is widely used for several physiological, behavioural, addictive, and medicinal purposes. It is a well-established "cooling and analgesic agent". However, the exact cellular and sub-cellular responses of menthol is poorly understood. In this work, we have characterized the effects of menthol on mitochondrial metabolism. Menthol regulates mitochondrial Ca, ATP, superoxides, cardiolipin, membrane-potential, and ER-mito contact sites. Moreover, the cooling agent menthol also cools down mitochondria and protects mitochondrial damage by certain toxins. These findings may promote use of menthol as a useful supplementary agent for anti-aging, anti-cancer, anti-inflammatory purposes where higher mitochondrial temperature is prevalent.
Topics: Humans; Menthol; Cardiolipins; Mitochondria; Structure-Activity Relationship; Adenosine Triphosphate; Calcium
PubMed: 37604353
DOI: 10.1016/j.lfs.2023.122032 -
Drug and Alcohol Dependence May 2024In addition to imparting flavor, menthol in menthol-flavored cigarettes enhances nicotine addiction and increases experimentation, initiation, and progression to regular... (Review)
Review
INTRODUCTION
In addition to imparting flavor, menthol in menthol-flavored cigarettes enhances nicotine addiction and increases experimentation, initiation, and progression to regular smoking. Menthol can be added to cigarettes at perceptible levels (so-called flavored cigarettes or characterized flavored cigarettes) or non-perceptible levels (subliminal). Our objective was to understand the reasons that tobacco companies use subliminal menthol.
METHODS
We identified previously secret internal tobacco company documents dated 1955-2012 in the Truth Tobacco Industry Documents archive on menthol at subliminal levels.
RESULTS
Beginning in at least the 1950s, tobacco companies used subliminal menthol to compensate the flavor loss caused by filters, reduce smoke harshness, reduce dryness, and increase smoke coolness. Varying menthol concentrations were considered to help convert people who smoke non-menthol to menthol brands, possibly because people who use menthol cigarettes have more harship quitting than people who use non-menthol cigarettes.
CONCLUSIONS
Menthol is an important additive beyond its function as a "characterizing flavor." Tobacco companies use menthol in "non-menthol" cigarettes at subliminal (non-perceptible by the people who smoke cigarettes) levels to improve taste, make them easier to smoke and facilitate initiation, and possibly convert people who smoke non-menthol cigarettes to menthol cigarettes.
PubMed: 38870568
DOI: 10.1016/j.drugalcdep.2024.111346