This article introduced search methods for adverse effects of healthcare interventions in MEDLINE, EMBASE and CBM (Chinese Biomedical Literature Database). The search strategies included the selection of publication type and the determination of medical subject headings and keywords both in English and Chinese, which will help identify relevant reports.
PURPOSE:To assess the effects of silicone oil removal on the complications associated with its use. METHODS:Retrospective analysis of the results of silicone oil removal after vitreous surgery for retinal detachment in 913 eyes in National Ophthalmology Centre of French. The follow-up period was at least six months and the mean duration of oil tamon- ade was 6.4 months. RESULTS :Retinal detachment recurred in 7.3%. The development of cataract continued after silicone oil removal. No patient retained a clear lens in the eye with oil remained in situ for more than 3 months. TWO of 5 eyes with keratopathy at the time of oil removal recovered after the oil removal ;but the corneas of another 4 eyes became dystrophic after the oil removal. Twelve of 15 eyes with secondary ocular hypertension incontrollable through medicinal treatment relieved after oil removal ,but another 11 eyes became hypertensive after oil removal. Persistent emulsive droplets wre found in anterior chamber angles of the above 11 hypertensive eyes and the 7 eyes with keratopathy. CONCLUSINOS:Early removal of silicone oil after retinal detachment operation might delay the development of cataract but can not avoid its occurence ,and ocular hypeitension and keratopathy can be prevented by early and complete removal of silicone oil. Chin J Ocul Fundus Dis,1997,13: 22-23）
Although anaphylaxis induced by vitamin K1 seldom happens, 4 allergic cases were observed in the patients we treated recently who were given intramuscular injection of vitamin K1 before renal biopsy. To provide the best clinical evidence, we searched MEDLINE （-May 2005） and evaluated the studies. The studies were only case reports and retrospective reviews which showed the anaphylaxis were mainly allergic dermatitis with different manifestation and reaction time. The serious reactions such as allergic shock was very rare. We conclude that although vitamin K1 anaphylaxis is rare, strict indications should be followed and the drug surveillance on adverse events should be strengthened.
ObjectiveTo provide references for postoperative analgesia treatment for cirrhotic patients with bone fracture. MethodsOne elderly patient with liver cirrhosis and fracture was admitted to our hospital on July 9, 2013. We obtained medical evidences by searching databases and regulated the best treatment after evaluating the patient's comprehensive conditions. And then, the whole treatment strategy was fully implemented. Finally, the consequent results were evaluated. ResultsWe identified 22 relevant articles including one clinical guideline, three cochrane reviews, five systematic reviews, seven small sample randomized controlled trials, one high quality observational study, and five quantitative reviews. We found that opioid analgesics utilization combined with non-opioid analgesics could not only reduce the occurrence of opioid drug adverse reactions, but increase analgesia safety. Cox-2 inhibitors could be used as the first choice of non-opioid drugs due to the less adverse reaction and better analgesic effectiveness. ConclusionFor femur fracture patients with liver cirrhosis, treatment decision based on evidence-based medicine is more scientific, which can ensure maximum benefit for the patients.
ObjectiveTo evaluate the treatment retention rate of five new types of antiepileptic drugs:lamotrigine (LTG), topiramate (TPM), oxcarbazepine (OXC), levetiracetam (LEV) and gabapentin (GBP) and their tolerability. MethodsA total of 216 patients diagnosed as epilepsy by receiving the long-term video electroencephalography monitoring between October 2012 and October 2014 were randomized into five drug treatment groups (LTG, n=57; TPM, n=42; OXC, n=49; LEV, n=47; GBP, n=21) and received corresponding dose of drug therapy. The seizure frequency, adverse events and number of patients giving up therapy were collected and recorded via phone or interview every 4 weeks. Every follow-up retention rate of every drug group equals current patient number continuing therapy/initial patient number of this drug group×100%. When the trial ended, Kaplan-Meier curve and Cox proportional risk model were applied for statistical analysis. ResultsThe trial lasted for 106 weeks. The final retention rate of LTG was the highest (85.9%), and GBP was the lowest (14.3%). Most patients could continue the therapy until the end of the trial after 24 weeks. The leading causes of discontinuing therapy included:no efficacy, rash, sedation and aggressive behavior. ConclusionThe retention rate of new types of antiepileptic drugs is associated with these elements:drug efficacy, adverse events, individual tolerability of drug, drug accessibility and the patients' individual preference of drug administration.
Protamine, which can be used to neutralize the anticoagulant effect of heparin in terms of surgical field extensively, is a kind of polycationic peptide extracted from the mature spermary of fish and mammal. While protamine brings convenience for clinical practice, it also produces some adverse reactions, which even endanger the patient's life. The clinical workers, therefore, pay more attention to the prevention and monitoring of adverse reactions of protamine. This paper introduces the mechanism of the interaction between protamine and heparin, monitoring methods and adverse reaction types. Furthermore, it reviews the current prevention methods of its adverse reactions, its application scale, as well as its existing problems in various clinical disciplines, suggesting that the modification of protamine from the perspective of molecular biology and genetic biology may strengthen its drug efficacy and reduce its adverse reactions, which will be the research highlights in the near future.
ObjectiveTo overview the systematic reviews (SRs) on the efficacy of traditional Chinese medicine (TCM) in the treatment of atrial fibrillation.MethodsPubMed, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data and VIP database were electronically searched to collect SRs of TCM in the treatment of atrial fibrillation from inception to July 2019. Two researchers independently screened literature, extracted data and then the methodological quality, reporting quality and evidence quality of the included documents were evaluated by AMSTAR2 tool, PRISMA statement and GRADE method.ResultsA total of 20 SRs were included. In which, 15 SRs evaluated clinical efficacy and 12 SRs analyzed adverse reactions. The methodological quality evaluation by AMSTAR2 was generally low and none of them being high quality, 1 of them being low quality and 19 of them being extremely low quality. The items with poor scores were item 2, 7, 8, 9, 10, 12, 13, 14 and 16. The PRISMA score ranged from 14 to 22.5. The quality question of the report was mainly manifested in the aspects of scheme and registration, data item, other analysis methods and sources of fundings. Evidence quality evaluation of GRADE outcome indicators was generally low.ConclusionTraditional Chinese medicine for atrial fibrillation can improve clinical efficacy and reduce adverse reactions. The overall methodological quality of the included literature is not high, and the quality of evidence is generally low. It suggest that further high-quality clinical studies should be carried out to provide a basis for evaluating the clinical efficacy of traditional Chinese medicine in treatment of atrial fibrillation.
ObjectiveTo systematically review the safety of hand disinfectants. MethodsPubMed, EMbase, The Cochrane Library, INAHTA, WanFang Data, CNKI and VIP databases were electronically searched to collect studies on the safety of hand disinfectants from inception to February 1st, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, a systematic review was conducted. ResultsA total of 50 studies were included. The reported adverse events were eye and nasal mucosal irritation, hand adverse events with skin itching, rash, erythema, edema and so on. A total of 29 brands such as 3M Avagard and 26 ingredients such as ethanol were reported to be related to the above adverse events. Hand disinfectants containing glycerin, silicone oil, vitamin B, plant extracts and other emollients could reduce the incidence of adverse events. ConclusionCurrent evidence shows that hand disinfectants containing emollients and free from ethanol, chlorhexidine and other ingredients are related to fewer adverse events. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.