scholarly journals Do Herbal Formulas Influence the International Normalized Ratio of Patients Taking Warfarin? A Retrospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Hsu-Yuan Lu ◽  
Seung-Yeon Cho ◽  
Seong-Uk Park ◽  
Woo-Sang Jung ◽  
Sang-Kwan Moon ◽  
...  

Warfarin is a common anticoagulant agent for cardiovascular diseases, and it is known to interact with several foods and drugs. Several studies report an interaction between warfarin and herbal medicines; however, the influence of herbal medicines on the international normalized ratio (INR) is still controversial. We investigated the influence of herbal formulas on INR of patients taking warfarin. We searched electronic medical records of inpatients for INR results. Then, we compared the changes in INR and any adverse events between the group taking herbal formulas and warfarin (herbal group) and another group taking warfarin only (nonherbal group). Eighty-six patients were included; 45 patients were assigned to the herbal group and 41 patients to the nonherbal group. The herbal group had taken the same dose of warfarin for a longer period. The nonherbal group had a slightly higher mean INR value than the herbal group. The ratio of INR less than 2 and greater than 3, the ratio of INR that increased or decreased by one or more compared to the initial INR, and the ratio of adverse events were not significantly different between the two groups. It is suggested that use of herbal formulas may not influence INR value.

2018 ◽  
Vol 35 (4) ◽  
pp. 189-197 ◽  
Author(s):  
Kian Karimi ◽  
Chester F. Griffiths ◽  
Alex Reivitis ◽  
Austin Davis-Hunter ◽  
Elizabeth Zhang ◽  
...  

The microcannula technique has become an increasingly popular method for injecting cosmetic fillers. Previous studies have illustrated that the microcannula technique allows filler to be injected with less pain, swelling, and essentially no bruising. This study is a retrospective clinical series examining 247 patients who have undergone dermal filler injections using the microcannula technique from 2011 to 2016 with a single injector, Kian Karimi. The purpose of this study is to assess the frequency of adverse events associated with injections such as bruising and swelling. All 666 recorded patient visits from 2011 to 2016 were analyzed using electronic medical records based on the criteria that the patients had cosmetic filler using the microcannula technique by the surgeon investigator. Of the 666 filler treatments using the microcannula technique, 3 treatments (0.5%) produced adverse events on the day of service, and 32 treatments (4.8%) produced adverse events at 2-week follow-up. In total, 5.4% of treatments produced adverse events. At the 2-week follow-up, 5.7% of treatments using the 25-gauge microcannula produced adverse events ( P = .830); 3.9% of treatments using the 27-gauge microcannula produced adverse events ( P = .612]). Only 3 patients were treated with the 30-gauge microcannula, and 1 patient reported adverse events on the day of service. None of the treatments using the 30-gauge microcannula produced adverse events at the 2-week follow-up ( P = .160). The data support that the microcannula technique is a safe and effective alternative to hypodermic needles for the injection of dermal filler to minimize common adverse events.


2016 ◽  
Vol 24 (2) ◽  
pp. 323-330 ◽  
Author(s):  
Alexandre Caron ◽  
Emmanuel Chazard ◽  
Joris Muller ◽  
Renaud Perichon ◽  
Laurie Ferret ◽  
...  

Background: The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety. Objective: To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases. Material and Methods: We developed IT-CARES, an analytical tool implementing case-crossover design, to explore the association between exposures and outcomes. The exposures and outcomes are defined by clinical epidemiologists via lists of codes entered via a user interface screen. We tested IT-CARES on data from the French national inpatient stay database, which documents diagnoses and medical procedures for 170 million inpatient stays between 2007 and 2013. We compared the results of our analysis with reference data from the literature on thromboembolic risk after delivery and bleeding risk after total hip replacement. Results: IT-CARES provides a user interface with 3 columns: (i) the outcome criteria in the left-hand column, (ii) the exposure criteria in the right-hand column, and (iii) the estimated risk (odds ratios, presented in both graphical and tabular formats) in the middle column. The estimated odds ratios were consistent with the reference literature data. Discussion: IT-CARES may enhance patient safety by facilitating clinical epidemiological studies of adverse events following medical procedures. The tool’s usability must be evaluated and improved in further research.


2021 ◽  
Vol 29 (1) ◽  
pp. 30-33
Author(s):  
VITOR LUIS PEREIRA ◽  
BERNARDO LOPES CRISOSTOMO ◽  
GIULIA CARVALHO SILVA ◽  
EIFFEL TSUYOSHI DOBASHI

ABSTRACT Objective: The aim of this work is to provide evidence for the relationship between suspicion and diagnosis of cases of child abuse and fractures, since, in national literature, studies are still scarce on the subject. Methods: Retrospective study involving electronic medical records of a public reference hospital, in a city of the state of São Paulo, in a 8-year period (2010 to 2018). Cases involving children up to 12 years of age were selected when notified as abuse and presenting fractures; data were statistically analyzed. Results: Among 83 cases of abuse, 19 patients (20.5%) had 23 different fractures. The victims were mainly boys (68.42%) with a mean age of 5 years old, who suffered physical aggression (79%). The majority had no identified aggressor (52%) and 21% were related to the mother. The fracture patterns found involved, mostly, skull fractures (43.48%) and diaphysary fractures (34.78%). Seven patients (30.43%) had other associated lesions and four patients died (21%). Conclusion: Despite the number of cases, it was possible to identify relevant characteristics and patterns. These data indicate that the diagnosis is underestimated and show small epidemiological differences compared with international literature. Level of Evidence II, Retrospective study.


2020 ◽  
pp. 096452842092030
Author(s):  
Ju-Ying Ang ◽  
Kavita Bhojwani ◽  
Huan-Keat Chan ◽  
Ai-Chen Chan

Introduction The objective of this retrospective study was to evaluate the effectiveness and safety of acupuncture-assisted anesthesia (AAA) in breast lump excision. Methods The medical records of all patients who underwent breast lump excision under AAA in combination with electrical stimulation at traditional acupuncture points in 2016 were examined. All of them (n = 17) received electrostimulation (2–4 Hz) using single needles inserted at bilateral LI4 and PC6. They also underwent insertion of four acupuncture needles at the lump site, which were electrically stimulated at 30 Hz frequency. Results All surgical procedures were successful with minimal use of analgesics and local anesthetic. The median pain score reported was 1/10 (interquartile range (IQR) = 2/10) at the first hour, and slightly increased to 2/10 (IQR = 2/10) between 24 and 48 h of the surgery. No major postoperative adverse events were documented, except for drowsiness in one case. Conclusion AAA was found to be generally safe and effective for anaesthesia and analgesia in breast lump excision. However, a large-scale randomized controlled study is required to verify the findings.


Sign in / Sign up

Export Citation Format

Share Document