Archive for category: Hematology

The CACTUS Trial: Anticoagulation for Symptomatic Calf Deep Vein Thrombosis?

12 Dec
December 12, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The optimal management of isolated calf deep vein thrombosis (DVT) is not completely clear, based on the available evidence. The authors of this paper state up to 50% of all lower extremity DVTs are infra-popliteal. Because there is not a lot of robust evidence to guide us on […]

Should I Stay or Should I Go: Outpatient Treatment of Venous Thromboembolism

05 Dec
December 5, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The care of venous thromboembolism (VTE) is currently undergoing a paradigm shift in the US with an increasingly large percentage of patients being discharged home from the Emergency Department (ED).  It wasn’t too long ago that all patients diagnosed with deep vein thrombosis (DVT) and pulmonary embolism (PE) […]

Treatment of Submassive Pulmonary Embolism (PE): Full Dose, Half Dose, or No Dose?

03 Nov
November 3, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketSubmassive pulmonary embolism (PE) is responsible for approximately 20% of all PEs.  Although the in-hospital mortality has been reported as about 5%, there is significant morbidity associated with this diagnosis such as chronic pulmonary hypertension, impaired quality of life, persistent right ventricular disfunction, and recurrent venous thromboembolism.  The literature […]

Hemophilia: What’s so Bloody Funny?

13 Apr
April 13, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketToday, I gave a lecture on Hemophilia to our residents in San Antonio, TX.  Now this was a core content lecture that I have actually never given before. As I was preparing the lecture I realized that this is a diagnosis that comes up frequently enough that it is important […]

Noreversaban?

05 Nov
November 5, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketWe have written about the new Non-Vitamin K Oral Anti Coagulants (NOACs). Many have jokingly referred to them as the “Noreversabans.” Taking these drugs is a high risk, high reward type of decision. While we recognize the benefits of quick anticoagulation without a need to bridge, as well as […]

Dancing with the Devil: Taking Dabigatran to the OR

31 Aug
August 31, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketSo you are minding your own business working in the ED at Big Hospital, when two dudes (paramedics) bring in a patient with abdominal pain. As luck would have it, this person has a perforated bowel and needs surgery pretty quickly. AND they are on, yes you guessed it… […]

Minor Head Trauma in Anticoagulated Patients: Admit for Observation or Discharge?

20 Jul
July 20, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: In elderly patients on chronic anticoagulation (i.e. warfarin and clopidogrel), falls have been shown to increase the incidence of intracranial hemorrhage (ICH) versus those not on anticoagulation (8.0% vs 5.3%). Mortality in those with ICH on anticoagulation is also higher than those who are not (21.9% vs 15.2%). Patients […]

May 2015 REBELCast

14 May
May 14, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketWelcome to the May 2015 REBELCast, where Swami, Matt, and I are going to tackle a couple of articles just published this year.  First, there is a lack of research examining the efficacy of steroids in patients with allergic reactions or anaphylaxis. Despite this, corticosteroids are standard care for patients […]

Topical Tranexamic Acid for Epistaxis or Oral Bleeds

14 Jul
July 14, 2014

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketRecently, there has been a lot of buzz about the use of topical tranexamic acid for epistaxis or oral bleeds on multiple social media platforms. Everyone seems so happy that it works so well, but we thought we would look through the literature and see what the evidence for use […]

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