Platelet dysfunction induced by herbal supplements in a patient with mild hemophilia A

Journal of Thrombosis and Haemostasis (Impact Factor: 5.72). 01/2008; 5(12):2556-8. DOI: 10.1111/j.1538-7836.2007.02765.x
Source: PubMed
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    Full-text · Article · Dec 2009 · Clinical and Applied Thrombosis/Hemostasis
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    ABSTRACT: Case reports provide essential information on adverse effects. Yet there is little consistency in the quality and format of reporting them. In this study, we aimed to assess the quality of case reports of adverse effect of herbal medicinal products (HMPs) published during three time periods, 1986-1988, 1996-1998, and 2006-2008. We conducted literature searches in four major databases: Medline, EMBASE, AMED, and CINALH. Each case report was subject to specific inclusion criteria related to the intervention (i.e. herbal medicine) and outcome measurement (i.e. adverse effect). A 21-item scale was used to assess the quality of all included reports. Each report was categorised into low quality (score between 0 and 14), lower medium quality (score between 15 and 21), upper medium quality (score between 22 and 28), and high quality (score between 29 and 42). In total, 137 case reports were included. The percentage of high quality case reports rose from 0% in 1986-1988 to 27.9% in 1996-1998 and 34.2% in 2006-2008; conversely, the percentages of low quality case reports dropped from 13.3% in 1986-1988 to 0% in 1996-1998 and 2.5% in 2006-2008. These findings are consistent with the notion that the quality of case reports is improving. However, due to several caveats, our data should be interpreted with caution.
    No preview · Article · Mar 2011 · Phytomedicine: international journal of phytotherapy and phytopharmacology
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    ABSTRACT: On-demand therapy with recombinant activated factor VII (rFVIIa) can provide effective haemostasis for spontaneous bleeds in haemophilia patients with inhibitors. However, treatment approaches vary amongst physicians, positively or negatively affecting outcomes. A panel of physicians proposed recommendations for securing and maintaining predictable efficacy with rFVIIa, comparing these with 'real-life' patient management, using a questionnaire circulated to other expert physicians from haemophilia care centres in Europe and the United States. For rFVIIa treatment of spontaneous bleeds in inhibitor patients, early intervention with the highest appropriate dose is recommended. Home-based therapy can facilitate early intervention. If additional rFVIIa therapy is required after the initial dose, rFVIIa 90 μg kg(-1) may be administered at 2-3 h intervals. Treatment should be tailored to bleed site/severity, recognizing the advantages of appropriate adjunct therapy. Questionnaire results suggested that many respondents adopted strategies in line with the recommendations. Most (36/46) recommended initial therapy within 1 h of bleed onset. rFVIIa 270 μg kg(-1) was the most frequently prescribed/recommended initial dose for paediatric (aged ≤ 15 years; 22/44 respondents) and adult (aged > 15 years; 23/44 respondents) patients. However, there may be opportunity for improved bleed management on occasion, with regard, for instance, to dosing and dose interval. To secure and maintain predictable efficacy with rFVIIa, judicious dose selection and treatment timing are important, together with adjunct therapy where necessary. As inhibitor patients present with different bleeding scenarios, a tailored treatment approach should be adopted.
    No preview · Article · Jul 2011 · Haemophilia
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