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The optimal duration of oral anticoagulation therapy after an initial symptomatic deep venous thrombosis remains unknown. Siragusa et al assessed patients by ultrasonography for the presence of residual vein thrombosis (RVT) after three months of anticoagulation for a DVT. Those with RVT were randomized to 9 additional months of anticoagulation versus discontinuation. Among the 70% with RVT, prolonged anticoagulation showed only a non-significant trend for reducing recurrent DVT. For the 30% without RVT, all of whom stopped anticoagulation after three months, only one of 78 patients (1.3%) developed a recurrent DVT. For select patients, the lack of RVT after initial anticoagulation identifies patients in whom anticoagulation may be safely discontinued. The optimal duration of anticoagulation for higher risk patients, including those with RVT, remains undefined.
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In spite of institutional education regarding appropriate use of prophylactic antibiotics, compliance was achieved only when hospital protocols that mandated specific antibiotic use were implemented.
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Although anemia was predictive of adverse outcomes in patients with aneurysmal subarachnoid hemorrhage, red blood cell transfusion was also associated with an increased risk of death, severe disability or delayed infarction. These results call into question the practice of liberal transfusion thresholds in patients with spontaneous subarachnoid hemorrhage.
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Some women with DVT may stop warfarin after six months; Vytorin and cancer; preventing recurrent stroke; and FDA news.
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Back pain is a ubiquitous complaint in the primary care setting. The evaluation and management of these patients varies based on several risk factors for serious disease called the red flags of back pain.
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The Planetree model is almost 30 years old but its essence is timeless, says Janet Powell Morin, RN, chief culture officer and former vice president, patient care services at Mid-Columbia Medical Center (MCMC) in The Dalles, OR.
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Dealing with too much data is "like drinking from a fire hose," says David A. Snyder, MD, vice president of patient care quality and safety at MCG Health in Augusta, GA.
