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Anticoagulation with vitamin k antagonists is the standard recommendation for patients with nonvalvular atrial fibrillation and risk factors for stroke. The benefits of warfarin in such patients have been well shown in many clinical trials. Therapy with warfarin, however, is often complicated by the dietary and drug interactions, so that even with frequent monitoring, precise control of the anticoagulation level is difficult.
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The differentiation of constrictive pericarditis from restrictive cardiomyopathy can be difficult, but the treatment implications are great.
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Patients with a positive CT scan for coronary calcium often have a stress test. Askew and colleagues from the Mayo Clinic asked whether such patients should undergo repeat stress testing if the first one is negative or low risk?
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In this issue: Does erythropoietin worsen cancer death rates? Most hypothyroid patients can be replaced with levothyroxine alone without additional T3. Does aggressive control in type 2 diabetes save lives?
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This multicenter randomized trialnicknamed the VISEP studyused a two-by-two factorial design to test two independent treatments in severe sepsis patients.
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Stop smoking drug Chantix rates stronger warning from FDA; Type 2 diabetes surgery on the way?; Vytorin study inconclusive; Influenza A virus found resistant to Tamiflu; FDA actions.
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Most cases of thrombocytopenia seen are expected. Patients are known to have hematological disease or are receiving chemotherapy. At times, however, the physician is confronted with an unexpected laboratory finding in an asymptomatic patient, or with a patient who is bleeding. The challenge, as usual, is to determine the need for acute treatment and the appropriate disposition.
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