Image-guided treatment shown to break the migraine cycle

An innovative interventional radiology treatment has been found to offer chronic migraine sufferers sustained relief of their headaches, according to research being presented at the Society of Interventional Radiology's Annual Scientific Meeting. Clinicians at Albany Medical Center and the State University New York Empire State College in Saratoga Springs used a treatment called image-guided, intranasal sphenopalatine ganglion (SPG) blocks to give patients enough ongoing relief that they required less medication to relieve migraine pain. "Migraine headaches are one of the most common, debilitating diseases in the Unites States, and the cost and side effects of medicine to address migraines can be overwhelming," said Kenneth Mandato, M.D., the study's lead researcher and an interventional radiologist at Albany Medical Center. "Intranasal sphenopalatine ganglion blocks are image-guide, targeted, breakthrough treatments. They offer a patient-centered therapy that has the potential to break the migraine cycle and quickly improve patients' quality of life," he added. Mandato and his team conducted a retrospective analysis of 112 patients suffering migraine or cluster headaches. Patients reported the severity of their headaches on a visual analogue scale (VAS), ranging from 1-10, to quantify the degree of debilitation experienced from the migraine. During the treatment, which is minimally invasive and does not involve needles touching the patient, researchers inserted a spaghetti-sized catheter through the nasal passages and administered 4 percent lidocaine to the sphenopalatine ganglion, a nerve bundle just behind the nose associated with migraines. Before treatment, patients reported an average VAS score of 8.25, with scores greater than 4 at least 15 days per month. The day after the SPG block patients' VAS scores were cut in half, to an average of 4.10. Thirty days after the procedure, patients reported an average score of 5.25, a 36 percent decrease from pretreatment. Additionally, 88 percent of patients indicated that they required less or no migraine medication for ongoing relief. "Administration of lidocaine to the sphenopalatine ganglion acts as a 'reset button' for the brain's migraine circuitry," noted Mandato. "When the initial numbing of the lidocaine wears off, the migraine trigger seems to no longer have the maximum effect that it once did. Some patients have reported immediate relief and are making fewer trips to the hospital for emergency headache medicine," he said. Because of the minimally invasive nature of the treatment and the medication's safety profile, Mandato believes patients can have the SPG block repeated, if needed. While patients reported relief from their migraines, Mandato added that SPG blocks are not a cure for migraines; they are a temporary solution as are other current treatment options for chronic headaches. Because of the minimally invasive nature of the treatment and the medication's safety profile, Mandato believes patients can have the SPG block repeated, if needed. To further study SPG blocks, Mandato will track how the 112 patients have responded six months after treatment. He is also considering conducting a double-blind, prospective study to more rigorously evaluate the effectiveness of SPG blocks in treating chronic migraines. Story Source: The above story is based on materials provided by Society of Interventional Radiology. Note: Materials may be edited for content and length.

Interventional radiology treatment relieves chronic plantar fasciitis

Patients suffering from chronic plantar fasciitis now have a new weapon against this debilitating foot ailment, according to research presented at the Society of Interventional Radiology's Annual Scientific Meeting. Researchers utilized ultrasound imaging and specific ultrasonic energy to penetrate, emulsify and remove diseased fasciitis tissue. Permanently removing damaged, pain-generating tissue allowed room for healthy tissue to regrow in its place, restoring normal function. "Plantar fasciitis is so ubiquitous and such a difficult condition to live with, and yet patients have been limited in their treatment options," said Rahul Razdan, M.D., one of the study's researchers and an interventional radiologist at Advanced Medical Imaging in Lincoln, Neb. "While standard treatments, such as pain medication and physical therapy, can offer some relief, there have been no permanent answers. Consequently, safe and effective definitive treatments are highly desirable," he noted. In the study, 100 patients were treated, beginning in August 2013. The patients presented with chronic, refractory plantar fasciopathy, and all patients had previously failed to respond to medications, activity modification and arch supports. Before treatment, patients reported how their foot pain affected their ability to manage everyday life through the Foot and Ankle Disability Index (FADI). FADI scores were collected from the patients at two weeks, six weeks and six months post treatment. Two weeks after treatment, greater than 90 percent of patients reported improvement in symptoms, and these improvements were maintained at six months. Patients also reported being highly satisfied with the treatment and had no treatment-related complications. "It is important for patients suffering from chronic plantar fasciitis to know that they have treatment options," added Razdan. "We have patients who are in so much pain they can't even play with their kids or take their dog for a walk. This ultrasonic treatment can give patients their lives back and let them enjoy their lives. We are excited to see significant results from this treatment," he said. Chronic plantar fasciitis is the most common debilitating foot complaint, affecting approximately 10 percent of the population and accounting for more than 1 million office visits annually, said Razdan. Story Source: The above story is based on materials provided by Society of Interventional Radiology. Note: Materials may be edited for content and length.

Minhas músicas preferidas /7/ True Love

Reasons for ibrutinib therapy discontinuation in CLL

About 10 percent of patients with chronic lymphocytic leukemia (CLL) discontinued therapy with the Bruton tyrosine kinase (BTK) inhibitor drug ibrutinib because of disease progression during clinical trials, according to a study published online in JAMA Oncology. CLL is the most prevalent leukemia in adults and it is not considered curable without an allogeneic (donor) stem cell transplant. However, advances in therapy have been made, notably the emergence of kinase inhibitors for patients whose disease relapsed, according to the study background. The drug ibrutinib (marketed as Imbruvica®) is the first drug designed to target Bruton's tyrosine kinase (BTK), a protein essential for CLL-cell survival and proliferation. The drug is approved by U.S. Food and Drug Administration in chronic lymphocytic leukemia and mantle cell lymphoma. Much of the clinical and basic-science research that led to the approval of ibrutinib for CLL was performed by scientists at The Ohio State University Comprehensive Cancer Center -- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC -- James). Hematologists Kami Maddocks, MD, Jennifer Woyach, MD, and colleagues have now described the characteristics of patients who discontinued ibrutinib therapy and their outcomes in a group of 308 patients participating in four trials at The OSUCCC -- James. The study results show that with a median (midpoint) follow-up of 20 months, 232 patients (75 percent) remained on therapy, 31 (10 percent) discontinued because of disease progression and 45 discontinued for other reasons (including 28 because of infection, eight for other adverse events and nine due to other medical events). Disease progression included Richter's transformation (when the cancer becomes an aggressive lymphoma) or progressive CLL. Richter's transformation appeared to occur early and CLL progression later. Median survival after Richter's transformation was 3.5 months and 17.6 months following CLL progression, the results indicate. "These data enhance our understanding of how patients do on ibrutinib long-term and who is likely to relapse. We know that many patients will have very durable remissions with ibrutinib, and understanding which patients are at higher risk helps us select who might benefit from clinical trials investigating other new agents and combination therapies rather than starting ibrutinib treatment by itself," says Woyach, senior author of the study. "We have confirmed that specific gene mutations are seen in patients who relapse, which gives us an idea of other drugs that might be effective in these circumstances." OSUCCC -- James researchers conclude that this data confirms ibrutinib as an effective therapy and identifies, for the first time, baseline factors associated with ibrutinib therapy discontinuation. "Outcomes data show poor prognosis after discontinuation, especially for those patients with Richter's transformation. Patients with either progressive CLL or Richter's tend to require therapy quickly after ibrutinib is stopped, so having a plan in place for alternative therapy is necessary. This sub-segment of patients who relapse on ibrutinib remains a high research priority to identify new targets and new therapies, and we have multiple studies ongoing at the James to try to help these patients," adds Maddocks. Story Source: The above story is based on materials provided by Ohio State University Wexner Medical Center. Note: Materials may be edited for content and length. Journal Reference: Kami J. Maddocks, Amy S. Ruppert, Gerard Lozanski, Nyla A. Heerema, Weiqiang Zhao, Lynne Abruzzo, Arletta Lozanski, Melanie Davis, Amber Gordon, Lisa L. Smith, Rose Mantel, Jeffrey A. Jones, Joseph M. Flynn, Samantha M. Jaglowski, Leslie A. Andritsos, Farrukh Awan, Kristie A. Blum, Michael R. Grever, Amy J. Johnson, John C. Byrd, Jennifer A. Woyach. Etiology of Ibrutinib Therapy Discontinuation and Outcomes in Patients With Chronic Lymphocytic Leukemia. JAMA Oncology, 2015; DOI: 10.1001/jamaoncol.2014.218

Fitting in fitness: Finding time for physical activity

Finding time for fitness can be tough. The key is making it convenient. Consider these practical suggestions. By Mayo Clinic Staff You know fitness is important for your health and well-being. And you want to get more active, but your days are a blur of work, household chores, errands, and time with family and friends. Setting aside enough time to sleep — let alone exercise — can be tough. So how can you find time for fitness? The key is to be flexible and make fitness a way of life. And remember all physical activity — not just formal exercise programs — adds up to a healthier you. Fitting in fitness at home Time spent at home doesn't have to be couch potato time. To make fitness a priority at home: Wake up early. Get up 30 minutes earlier than you normally do and use the extra time to walk on your treadmill or take a brisk walk around the neighborhood. Make chores count. Mop the floor, scrub the bathtub or do other housework at a pace fast enough to get your heart pumping. Outdoor work counts, too. Mowing the lawn with a push mower is a great way to burn calories. Raking and hoeing strengthen your arms and back, and digging works your arms and legs. Be active while watching TV. Use hand weights, ride a stationary bike or do a stretching routine during your favorite shows. Get off the couch to change the channel or adjust the volume. Involve the whole family. Take group walks before or after dinner. Play catch. Ride your bikes. It's best to build up to about 30 minutes of continuous activity, but you can exercise in shorter bursts, too. Get your dog into the act. Take daily walks with Fido or Fluffy. If you don't have a dog, borrow one. An enthusiastic dog may give you the motivation you need to lace up your walking shoes. Next Work out at work To fit in more physical activity while you're on the job: Make the most of your commute. Walk or bike to work. If you ride the bus, get off a few blocks early and walk the rest of the way. Take the stairs whenever you can. If you have a meeting on another floor, get off the elevator a few floors early and use the stairs. Better yet, skip the elevator entirely. Take fitness breaks. Rather than hanging out in the lounge with coffee or a snack, take a short walk. Or invite colleagues to join you for a walking meeting. Start a walking group. The regular routine and the support of your co-workers may help you stick with the program. Put it on the calendar. Schedule physical activity as you would any other appointment during the day. Don't change your exercise plans for every interruption that comes along. Take it on the road. If you travel for work, plan ahead. Bring your jump-rope or choose a hotel that has fitness facilities. If you're stuck in an airport waiting for a plane, grab your bags and take a walk. More tips for fitting in fitness Here are a few more ways you can add more activity to your routine: Get more out of errands. When you go to the mall or grocery store, park toward the back of the lot and walk the extra distance. If you have a little extra time, walk inside for a lap or two before you start shopping. Keep a pair of walking shoes in your car so that you're ready when you find a few minutes for exercise. Get social. Make a date with a friend to hike in a local park, or take a family trip to the zoo. Try a dance club, hiking group or golf league. Encouragement from others can help you stay with a new activity. Team up. Sign up for a softball, soccer or volleyball team through your local parks and recreation department. Making a commitment to a team is a great motivator. Join the club. Sign up for a group exercise class at a nearby gym or fitness center. The cost may be an added incentive to stick with it. There's no single best way to fit physical activity into your day. Your lifestyle, job and family responsibilities will point to the most convenient time and place for fitness. Do what works for you — and make daily physical activity a habit you keep. Notice : The images above don’t belong to the original article.

Can money buy happiness? The relationship between money and well-being

Researchers are investigating new directions in the science of spending. Four presentations during the symposium "Happy Money 2.0: New Insights Into the Relationship Between Money and Well-Being," delve into the effects of experiential purchases, potential negative impacts on abundance, the psychology of lending to friends, and how the wealthy think differently about well-being. The symposium takes place during the SPSP 16th Annual Convention in Long Beach, California. Anticipation for experiential purchases Research published in the journal Psychological Science has shown that experiential purchases--money spent on doing--may provide more enduring happiness than material purchases (money spent on having). Participants reported that waiting for an experience elicits significantly more happiness, pleasantness and excitement than waiting for a material good. "The anticipatory period [for experiential purchases] tends to be more pleasant...less tinged with impatience relative to future material purchases we're planning on making," explains lead researcher Amit Kumar. In an analysis of stories in the news media about long lines, "Those waiting for an experience tended to be in a better mood and better behaved than those waiting for a material good." Given the results, the researchers suggest that it may make sense to delay consumption of some purchases, and shift spending away from material goods to more experiences. In short--start planning for vacations, dinner parties and concerts ahead of time to reap more benefits from anticipation. Abundance, adversity and savoring Can less really be more? Research published in Personality and Social Psychology Bulletin shows that both material and experiential wealth tends to reduce people's ability to savor simple joys and experiences. Wealth and abundance may undermine appreciation and reduce the positive emotions associated with everyday experiences. In contrast to abundance, experiencing adversity in the past or scarcity in the present increases individual's ability to savor everyday moments, according to a study published in Social Psychological and Personality Science (SPPS). "Simply reminding individuals that the future can be unpredictable drives people to stop and smell the roses," says lead researcher Jordi Quoidbach. Temporarily giving something up may provide an effective route to happiness, concludes another study published in SPPS. Consistently indulging in pleasure and abundance may not be the most productive route to happiness. The cost of lending money Researchers at UCLA and Harvard Business School are studying how lenders and borrowers differ in how they mentally account for loaned funds, and the expectations for how the money should be spent. The researchers showed that lenders were angriest when borrowers purchased hedonic (vs. utilitarian) items. In a follow up study, researchers distinguished lending from other types of exchanges, finding those who had loaned money (versus gifted or paid) reported the most anger towards those who purchased a hedonic item with the funds. A third study demonstrated lenders believe they are entitled to far more oversight over what the borrower purchases than borrowers believe lenders to be, especially for larger amounts of money. These results shed light on the root of the anger lenders feel when borrowers seem to 'misappropriate' their loan. "Our work shows that interpersonal lending can become an emotional minefield, especially for the lender and particularly when the borrower makes purchases that are hedonic rather than utilitarian," explains lead researcher Noah Goldstein. What do the wealthy need to be happy? Many people believe that becoming rich is the path to happiness, but pursuing wealth may be an ineffective means of pursuing well-being. According to a study from researchers at Harvard Business School, the University of Mannheim and Yale University, wealthy individuals report that having three to four times as much money would give them a perfect "10" score on happiness--regardless of how much wealth they already have. "Wealthy individuals--whether worth $1 million or $10 million--are not happier as their wealth increases," says lead researcher Michael Norton. The research shows that current happiness is not related to wealth and may even be negatively related to income. The study is expected to be published in the coming year. Story Source: The above story is based on materials provided by Society for Personality and Social Psychology. Note: Materials may be edited for content and length.

Finding psychological insights through social media

Social media has opened up a new digital world for psychology research. Four researchers will be discussing new methods of language analysis, and how social media can be leveraged to study personality, mental and physical health, and cross-cultural differences. The speakers will be presenting their research during the symposium "Finding Psychological Signal in a Billion Tweets: Measurement Through the Language of Social Media," at the Society for Personality and Social Psychology (SPSP) 16th Annual Convention in Long Beach, California. Collaborating with computer scientists Researchers have long measured people's thoughts, feelings, and personalities using survey questions. The widespread use of Twitter and Facebook has afforded new approaches to social science research, and requires new techniques to analyze and interpret data using computer science methods. These techniques allow researchers the ability to generate insights from large-scale data sets. "Collaborations between psychologists and computer scientists can yield studies and insights that would not likely have been conceived independently by researchers from either field," says Andy Schwartz of the University of Pennsylvania. A study utilizing open-vocabulary analysis found striking variations in language with personality, gender, and age. Certain words and phrases can provide novel and detailed insights. For instance, men used the possessive 'my' when mentioning their 'wife' or 'girlfriend' more often than women used 'my' with 'husband' or 'boyfriend.' Open-vocabulary analysis can find connections that are unanticipated and often are not captured by other analysis techniques. "Data-driven techniques are mostly limited to finding correlations rather than causation...Future analyses are moving beyond words to capturing less ambiguous meanings from language," explains lead researcher Andy Schwartz. Collaboration between social and personality psychologists, and computer scientists, will be integral to moving that research forward. Assessing personality with Facebook Researchers have found that words used on Facebook are surprisingly reliable indicators of personality. Their results are published in the Journal of Personality and Social Psychology. The researchers utilized predictive algorithms of the language to create efficient large-scale personality assessments. The automated language-based models of traits were consistent with the participants' self-reported personality measurements. Lead author Gregory Park confirms the reliability of the language-based model: "We evaluated the method in several ways. Predictions from the automated methods can accurately predict the scores the users receive on personality tests. They are consistent with personality ratings made by the users' actual friends, and other personality-related outcomes, such as the number of friends, or self-reported political attitudes." Another study, published in the journal Assessment, analyzed Facebook statuses of study participants using open-language analysis. The researchers generated word clouds that visually illustrated how several personality traits (extraversion, agreeableness, conscientiousness, emotional stability, and openness) appear on Facebook. The study found that certain phrases are predictive of specific personality traits. For example, individuals who score high in neuroticism on a self-reported personality assessments are more likely to use words like sadness, loneliness, fear and pain. Analyzing this data may provide novel connections that may not be apparent in traditional written questionnaires and surveys. Tracking community health through Twitter In a study recently published in the journal Psychological Science, researchers compared tweets and heart disease at the county level. The study found that language analyses may predict heart disease risk as well or better than traditional epidemiological risk factors. "Language associated with anger, negative emotions, hostility and disengagement within a community was associated with increased rates of heart disease," explains lead author Johannes Eichstaedt, "Language expressing positive emotions and engagement was associated with reduced risk." Twitter users are not necessarily individuals at-risk for heart disease, but rather, they can serve as canaries for communities with higher heart disease risk. Tweets can represent the overall negativity a community is feeling, and indicate the social and environmental stresses that contribute to increased heart-disease risk. The results of the study illustrate that Twitter serves as an accurate predictor of health and risk factors of a community. Eichstaedt and his colleagues are now analyzing words and phrases on Twitter to track depression and anxiety across populations. Cultural variation in language Social media allows researchers to examine similarities and differences across cultures at a new level. Cross-cultural studies typically require time-intensive qualitative analyses with a small number of people. Margaret Kern of the University of Melbourne and Maarten Sap of the University of Pennsylvania are using Twitter to study variations in language use across cultures. Using differential language analysis the researchers examined Twitter posts from eight countries (United States, Canada, United Kingdom, Australia, India, Singapore, Mexico, and Spain) and two languages (English and Spanish). The researchers found that there were many similarities across countries, with emoticons and iconic pop artists correlating with positive emotions and curse words, and aggression correlating with negative emotions. There were also differences that point to culture-specific correlations for emotional expression. Results of the study are still preliminary, and have not yet been published. "A challenge for us is understanding how to interpret any differences we see- is it a really difference, or simply noise? In the future, we hope to work directly with people from these cultures to help us interpret and understand the results," explains lead researcher Margaret Kern. Story Source: The above story is based on materials provided by Society for Personality and Social Psychology. Note: Materials may be edited for content and length.

Unlikely friendship

The Difference Between Research and Development

Tue, 02/24/2015 - 9:34am Bradford L. Goldense, President, Goldense Group Inc., Needham, Mass.   Figure 1: The Continuum of Research and Development. The already unclear lines separating research from development are getting even blurrier as more companies allocate some part of their R&D budget to take on riskier projects, and invest in the necessary infrastructure to manage these riskier activities. New products are now being launched out of recently formed "Innovation" organizations", and more are coming from existing “Advanced Development" organizations. Challenges of "Anywhere" R&D Several factors have complicated matters for industry observers trying to stay abreast of what might be coming to market by simply paying attention to product development pipelines. These factors include: The changing corporate approaches described above. The desires of developers to bring solutions to market, not just pieces of a solution. The globalization of R&D that has, in effect, decentralized R&D. Naming conventions for organizations that differ by industry and country. The jury is still out as to whether today's approaches to R&D will prove more productive than historical approaches. Historical approaches to pre-product development generally restricted the scope of activities to reduce uncertainty and improve the predictability of key enabling features, capabilities and technologies—and then turned those enablers over to product development. Traditional "Analog" R&D R&D is a continuum—highly analog rather than digital in its construct. In the 20th century, R&D could generally be segmented into four categories: Basic Research, Applied Research, Advanced Development and Product Development. "Skunk Works," perhaps a fifth category, is a discussion for another day. In Basic Research, discovery targets are broad. Scientists and researchers generally look for capabilities that have some efficacy with an articulated broad market or customer-based need. Some Basic Research is truly blue sky, but that has been on the decline the past few decades as few can afford it. Basic Research often just rules out things that won't work and identifies inventions that might work. Applied Research generally has a more specific target. It usually focuses on a known problem, business opportunity, or an application area where economic or social improvements are possible. Applied Research generally starts off by taking enablers that might work and attempts to narrow them down to the possible and likely feasible solutions. Advanced Development generally takes these possible and likely feasible solutions and further reduces the risk in hopes of culling out the best alternatives to deliver to an expressed target for a capability or feature to incorporate into products. Downstream manufactured cost considerations start to come into play as a culling consideration. Mentioned earlier, some advanced and innovation organizations actually bring the entire product to market. Finally, Product Development invents what’s needed and necessary “now” and packages both the form and function of all feasible and risk-reduced features and/or capabilities into products planned for release to the marketplace. Venn diagrams of each of these four historical R&D categories always overlapped, but the overlaps have grown in cadence with the growth of innovation emphasis this past decade. In short, research and advanced development organizations historically didn’t bring products with full form and function to market. Instead, they specialized in experimentation and analysis, combined with breadboards and brassboards to demonstrate feasibility. Form and function was the job of Product Development. Professionals in these pre-product development organizations were largely senior scientists and engineers who specialized in discovery and in narrowing-down feasibility issues. The knowledge of manufacturing capabilities and constraints, packaging, logistics, costing and other "product launch" disciplines were almost exclusively in the realm of Product Development. Today, the lines of organization purpose and demarcation aren’t as clear. "Analog vs. Anywhere" R&D The idea that any organization can launch a product has advantages. They include: Healthy competition between precut-releasing organizations. Broadening the skill sets of all developers. Keeping the entire development community close to the market and customer needs. And perhaps adding flexibility to the management of development capacity. On the other hand, there are also some disadvantages. The decline of specific subject matter experts may reduce the depth of company capabilities over the long term. When advanced or special innovation organizations get all the sweet projects, it sows dissatisfaction in the rest of the product development community. This is analogous to the way many feel when asked to exclusively focus on sustaining engineering or maintenance rather than new products. This can lead to unproductive time, often in the form of politicking. As well, some managers subtly alter or over represent their functional expertise to attain preferred projects. This can lead to duplication of staff, or projects over the heads of the people currently in the organization. The companies that are breaking from the analog continuum of research to development must remain vigilant to the possible downsides of change. An "Analog vs. Anywhere" Example Hard to internalize the historical R&D continuum?  Let's take the example of a self-piloted robotic lawn mower.  Lawn mowers are the realm of Product Development after decades of designing and producing them. Some advanced work might be necessary if one is trying to get better lift from the blade to push clippings into the collection bag. Some advanced work might be necessary for engines that have to operate regularly in extreme conditions, and/or with changing regulations on fuel chemistry. This past decade, significant advanced work has been necessary to develop all-wheel turning/steering for riding mowers. But, compared to those examples, a self-piloted lawn mower requires advanced work on just about every subsystem of the mower platform.  Energy management, torque in a scaled down size, handling the mower, fail-safing while it is running and piloting are just a few of robomower's challenges. Piloting is a great example to make the point. Steering robomower isn’t as easy as the robotic vacuum cleaner that changes direction when it bumps into something.  The vegetable garden and flower bed might get half mowed before "robo mower" bumped into anything hard enough to redirect it; and that wouldn’t be good.  The same applies for pets and curious children to say the least. Advanced development organizations are still culling among feasible alternatives to define the edges of yards and set the redirection of the mower. Impact sensing, infrared or heat sensing, current or magnetic sensing aka doggie wire, GPS, directly program the yard coordinates as part of user set-up, photograph or image-driven, and several others are all  feasible alternatives. Can you imagine the project schedule if Product Development had to cull out the best piloting approach while designing the rest of the mower that is fully integrated with the piloting system?  Applied Research and Advanced Development organizations could work for years to determine the most accurate and economical piloting technology for a robotic mower platform across the myriad of yard configurations and landscaping approaches before anything was ready for wheels and a blade. Conclusions Today, robomower might be brought to market from either an Advanced or a Product Development organization versus Advanced Development determining the best piloting technique and Product Development then bringing robo mower to market.  As well, an entire robomower might be the responsibility of an Innovation Organization or Skunk Works.

Warfarin side effects: Watch for interactions

Although commonly used to treat blood clots, warfarin (Coumadin, Jantoven) can have dangerous side effects or interactions that can place you at risk of bleeding. Here are precautions to take to avoid warfarin side effects. By Mayo Clinic Staff If you've been prescribed warfarin (Coumadin, Jantoven) to prevent blood clots, you probably already know that this powerful drug can save your life if you are at risk of or have had blood clots. But you may not realize how serious warfarin side effects can be. Warfarin, especially if taken incorrectly, increases your risk of dangerous bleeding. Warfarin side effects can also include interactions with some foods, prescription medicines and over-the-counter supplements. If your doctor prescribes warfarin for you, make sure you understand all the potential warfarin side effects and interactions it could have. When is warfarin prescribed? You might be given warfarin if you have: A blood clot in or near your heart that could trigger stroke, heart attack or organ damage A blood clot in your lungs (pulmonary embolism) A blood clot elsewhere in your body (venous thrombosis) A high risk of blood clots forming in the heart, which can be a complication of some heart rhythm abnormalities (arrhythmias) A mechanical artificial heart valve that is prone to forming blood clots What warfarin side effects should you watch for? When you take warfarin, your blood won't clot as easily. If you accidentally cut yourself while taking warfarin, you may bleed heavily. However, the risk of a major bleeding event is low. You're more likely to have bleeding problems if you're older than 75 or take other blood-thinning medications that can further increase your bleeding risk. You're also at higher risk of bleeding problems if you have: High blood pressure (hypertension) A history of stroke Kidney problems Cancer Alcoholism Liver disease Some studies suggest that bleeding problems are more likely to occur during the first month of taking warfarin rather than later in treatment. Warfarin side effects that require immediate medical attention Severe bleeding, including heavier than normal menstrual bleeding Red or brown urine Black or bloody stool Severe headache or stomach pain Joint pain, discomfort or swelling, especially after an injury Vomiting of blood or material that looks like coffee grounds Bruising that develops without an injury you remember Dizziness or weakness Rarely, warfarin can cause the death of skin tissue (necrosis). This complication occurs most often three to eight days after you start taking warfarin. If you notice any sores, changes in skin color or temperature, or severe pain on your skin, seek immediate medical care. Less serious warfarin side effects to tell your doctor about Bleeding from the gums after you brush your teeth Swelling or pain at an injection site Heavier than normal menstrual bleeding or bleeding between menstrual periods Diarrhea, vomiting or inability to eat for more than 24 hours Fever Next Jan. 06, 2015 References See more In-depth página 2 What precautions can you take against warfarin side effects? To reduce your chance of developing warfarin side effects: Tell your doctor about any other medications or supplements you take. Many medications and supplements can have a dangerous interaction with warfarin. If you receive a new prescription from someone other than your usual care provider, ask if you'll need additional blood tests to make sure the new medication isn't affecting your blood clotting. Tell care providers you take warfarin before you have any medical or dental procedures. It's important to share this information even before minor procedures, such as vaccinations and routine dental cleanings. If you're going to have surgery, you may need to decrease or discontinue your warfarin dose at least five days before the procedure. Your doctor might prescribe a shorter acting blood thinner, heparin, while you're not taking warfarin. Avoid situations that increase your risk of injury. Contact sports and other activities that could result in head injury should be avoided. Tell your doctor if you are unsteady while walking or have a history of falling. Use safer hygiene and grooming products. A soft-bristle toothbrush, waxed dental floss and an electric razor for shaving can help prevent bleeding. Consider wearing a bracelet or carrying a card that says you take warfarin. This identification can be useful if emergency medical providers need to know what medications you take. Consider a warfarin sensitivity test. A significant number of people who take warfarin are at a higher risk of bleeding because their genes make them more sensitive to warfarin. If a family member experienced side effects from warfarin, talk to your doctor about taking a genetic warfarin sensitivity test. The test can determine if you have the genes that can increase your risk of bleeding. What drugs and supplements can interact with warfarin? Like any other medication, warfarin can interact with foods, other drugs, vitamins or herbal supplements. The interaction might lower the effectiveness of warfarin or increase your risk of bleeding. More than 120 drugs and foods that can interact with warfarin have been identified. Drugs that can interact with warfarin include: Many antibiotics Antifungal medications, such as fluconazole (Diflucan) Aspirin or aspirin-containing products Ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve, Anaprox) Acetaminophen (Tylenol, others) or acetaminophen-containing products Cold or allergy medicines Medications that treat abnormal heart rhythms, such as amiodarone (Cordarone, Pacerone) Antacids or laxatives Many other medications interact with warfarin. Be sure to tell any health care provider or pharmacist that you take warfarin. Supplements that can interact with warfarin include: Coenzyme Q10 (ubidecarenone) Dong quai Garlic Ginkgo biloba Ginseng Green tea St. John's wort Vitamin E Many other supplements can interact with warfarin. Be sure to tell your health care provider about any supplements you take. What foods and drinks might interact with warfarin? Foods and drinks that might interact with warfarin include: Cranberries or cranberry juice Alcohol Foods that are high in vitamin K, such as soybean and canola oils, spinach and broccoli Garlic Black licorice Your doctor might recommend keeping the level of vitamin K in your diet consistent rather than avoiding vitamin K-rich foods altogether. What should you do if you forget a dose? Never take a double dose of warfarin. Doing so could greatly increase your risk of side effects. If you miss a dose, take it as soon as you remember. If you don't remember until the next day, call your doctor for instructions. If your doctor isn't available, skip the missed dose and start again the next day. If you follow your doctor's dosing instructions and tell all your health care providers that you take warfarin, you'll be at a much lower risk of dangerous interactions and side effects. Talk to your doctor, nurse or pharmacist if you have any concerns about warfarin.