December 28th, 2010 by RyanDuBosar in Opinion, Research
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This is a guest post by Dr. Juliet Mavromatis:
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The emergence of a new generation of anticoagulants, including the direct thrombin inhibitor, dabigatran and the factor Xa inhibitor, rivaroxaban, has the potential to significantly change the business of thinning blood in the United States. For years warfarin has been the main therapeutic option for patients with health conditions such as atrial fibrillation, venous thrombosis, artificial heart valves and pulmonary embolus, which are associated with excess clotting risk that may cause adverse outcomes, including stroke and death. However, warfarin therapy is fraught with risk and liability. The drug interacts with food and many drugs and requires careful monitoring of the prothrombin time (PT) and international normalized ratio (INR).
Recently, when I applied for credentialing as solo practioner, I was asked by my medical malpractice insurer to detail my protocol for monitoring patients on anticoagulation therapy with warfarin. When I worked in group practice at the Emory Clinic in Atlanta I referred my patients to Emory’s Anticoagulation Management Service (AMS), which I found to be a wonderful resource. In fact, “disease management” clinics for anticoagulation are common amongst group practices because of the significant liability issues. Protocol based therapy and dedicated management teams improve outcomes for patients on anticoagulation with warfarin. Read more »
*This blog post was originally published at ACP Hospitalist*
October 10th, 2010 by RyanDuBosar in Better Health Network, Health Tips, Humor, Opinion, Research
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Guest post by Dr. John Henning Schumann
I’m not a drum banger for the latest “epidemics” to come to media attention, whether it’s H1N1, Vitamin D, or getting your kids CAT-scanned routinely.
But there comes a time in every blogger’s life when he must comment on something that does bubble up into consciousness a tad, shall we say, often.
I’m talking here about an epidemic that we are learning more about each passing day. Something that you or someone you know or sleep with may be diagnosed with, and ultimately treated for (an interesting national problem in its own right): Obstructive sleep apnea (OSA).
What is it, you ask? A new national scourge? Stop the presses! Can I catch it? Read more »
*This blog post was originally published at ACP Hospitalist*
September 25th, 2010 by JessicaBerthold in Better Health Network, Health Tips, True Stories
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A version of the following post, by Kimberly Manning, FACP, appeared on the blog “Life at Grady.”
“My blood pressure is still borderline? Man!”
“Yeah…and from looking through the chart, it was 150/96 on your admission. It’s pretty much been that since you’ve been here, give or take a few points. That’s a little more than borderline, actually.” I paused for a moment, realizing that I sounded a bit discouraging. “I don’t think this would be hard to get under control at all, sir. I mean…you’re such a motivated patient, you know?”
I studied my patient carefully. He was in his late thirties, although he could totally pass for a twenty-something all day, every day. His skin looked like someone had grabbed him by the tip of his toe and uniformly dipped him in milk chocolate — not a single blemish anywhere.
“I eat right and I exercise…in fact, I’m a health nut! I’m really kind of surprised that my pressure keeps running high.” Read more »
*This blog post was originally published at ACP Hospitalist*
