Preventing and Treating Thromboembolism in the 21st Century

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Preventing and Treating Thromboembolism in the 21st Century

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A pharmacologic overview of current and emerging anticoagulants
Edith A. Nutescu, PharmD; Nancy L. Shapiro, PharmD; Aimee Chevalier, PharmD; and Alpesh N. Amin, MD, MBA

Prevention of venous thromboembolism in medical and surgical patients
Peter J. Kaboli, MD; Adam Brenner, BS; and Andrew S. Dunn, MD

Current and emerging options in the management of venous thromboembolism
Amir K. Jaffer, MD; Daniel J. Brotman, MD; and Franklin Michota, MD

Stroke prevention in atrial fibrillation: Current anticoagulation management and future directions
Benjamin T. Fitzgerald, MBBS; Steven L. Cohn, MD; and Allan L. Klein, MD

Heparin-induced thrombocytopenia: Principles for early recognition and management
John R. Bartholomew, MD; Susan M. Begelman, MD; and Amjad AlMahameed, MD

Anticoagulation in special patient populations: Are special dosing considerations required?
Franklin Michota, MD, and Geno Merli, MD

Cost considerations surrounding current and future anticoagulant therapies
Margaret C. Fang, MD, MPH; Tracy Minichiello, MD; and Andrew D. Auerbach, MD, MPH

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Cleveland Clinic Journal of Medicine - 72(4)
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S1-S49
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Supplement Editor:
Amir K. Jaffer, MD

Contents

A pharmacologic overview of current and emerging anticoagulants
Edith A. Nutescu, PharmD; Nancy L. Shapiro, PharmD; Aimee Chevalier, PharmD; and Alpesh N. Amin, MD, MBA

Prevention of venous thromboembolism in medical and surgical patients
Peter J. Kaboli, MD; Adam Brenner, BS; and Andrew S. Dunn, MD

Current and emerging options in the management of venous thromboembolism
Amir K. Jaffer, MD; Daniel J. Brotman, MD; and Franklin Michota, MD

Stroke prevention in atrial fibrillation: Current anticoagulation management and future directions
Benjamin T. Fitzgerald, MBBS; Steven L. Cohn, MD; and Allan L. Klein, MD

Heparin-induced thrombocytopenia: Principles for early recognition and management
John R. Bartholomew, MD; Susan M. Begelman, MD; and Amjad AlMahameed, MD

Anticoagulation in special patient populations: Are special dosing considerations required?
Franklin Michota, MD, and Geno Merli, MD

Cost considerations surrounding current and future anticoagulant therapies
Margaret C. Fang, MD, MPH; Tracy Minichiello, MD; and Andrew D. Auerbach, MD, MPH

Supplement Editor:
Amir K. Jaffer, MD

Contents

A pharmacologic overview of current and emerging anticoagulants
Edith A. Nutescu, PharmD; Nancy L. Shapiro, PharmD; Aimee Chevalier, PharmD; and Alpesh N. Amin, MD, MBA

Prevention of venous thromboembolism in medical and surgical patients
Peter J. Kaboli, MD; Adam Brenner, BS; and Andrew S. Dunn, MD

Current and emerging options in the management of venous thromboembolism
Amir K. Jaffer, MD; Daniel J. Brotman, MD; and Franklin Michota, MD

Stroke prevention in atrial fibrillation: Current anticoagulation management and future directions
Benjamin T. Fitzgerald, MBBS; Steven L. Cohn, MD; and Allan L. Klein, MD

Heparin-induced thrombocytopenia: Principles for early recognition and management
John R. Bartholomew, MD; Susan M. Begelman, MD; and Amjad AlMahameed, MD

Anticoagulation in special patient populations: Are special dosing considerations required?
Franklin Michota, MD, and Geno Merli, MD

Cost considerations surrounding current and future anticoagulant therapies
Margaret C. Fang, MD, MPH; Tracy Minichiello, MD; and Andrew D. Auerbach, MD, MPH

Issue
Cleveland Clinic Journal of Medicine - 72(4)
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Cleveland Clinic Journal of Medicine - 72(4)
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Preventing and Treating Thromboembolism in the 21st Century
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Special Issue: Women's Health

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Guest Editors:
Gurjit Kaur, DO, and Holly L. Thacker, MD

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Recognizing and intervening in intimate partner violence
Gurjit Kaur, DO, and Linda Herbert, LISW

New cervical cancer screening strategy: Combined Pap and HPV testing
Xian Wen Jin, MD, PhD; Kristine Zanotti, MD; and Belinda Yen-Lieberman, PhD

Cardiovascular problems and pregnancy: An approach to management
Samuel Siu, MD, and Jack M. Colman, MD

Treatment options for menopausal hot flashes
Andrea Sikon, MD, and Holly L. Thacker, MD

Shared medical appointments: Increasing patient access without increasing physician hours
David L. Bronson, MD, and Richard A. Maxwell, MD

Premenstrual dysphoric disorder: A review for the treating practitioner
Gurjit Kaur, DO; Lilian Gonsalves, MD; and Holly L. Thacker, MD

Update on contraception: Benefits and risks of the new formulations
Pelin Batur, MD; Julie Elder, DO; and Mark Mayer, MD

DXA scanning to diagnose osteoporosis: Do you know what the results mean?
Bradford Richmond, MD

Culture, race, and disparities in health care
Charles S. Modlin, MD

Physician cultural competence: Cross-cultural communication improves care
Anita D. Misra-Hebert, MD

What are the key issues women face when ending hormone therapy?
Wulf H. Utian, MD, BCH, PhD

Vertebral compression fractures: Manage aggressively to prevent sequelae
Daniel J. Mazanec, MD; Alex Mompoint, MD; Vinod K. Podichetty, MD; and Amarish Potnis, MD

The HIP trial: Risedronate prevents hip fractures, but who should get therapy?
Chad L. Deal, MD

Discussing breast cancer and hormone therapy with women
Pelin Batur, MD; Holly L. Thacker, MD; and Halle C.F. Moore, MD

The case for hormone therapy: New studies that should inform the debate
Holly L. Thacker, MD
 


 

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Issue
Cleveland Clinic Journal of Medicine - 72(4)
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Page Number
1-103
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Guest Editors:
Gurjit Kaur, DO, and Holly L. Thacker, MD

Contents

Recognizing and intervening in intimate partner violence
Gurjit Kaur, DO, and Linda Herbert, LISW

New cervical cancer screening strategy: Combined Pap and HPV testing
Xian Wen Jin, MD, PhD; Kristine Zanotti, MD; and Belinda Yen-Lieberman, PhD

Cardiovascular problems and pregnancy: An approach to management
Samuel Siu, MD, and Jack M. Colman, MD

Treatment options for menopausal hot flashes
Andrea Sikon, MD, and Holly L. Thacker, MD

Shared medical appointments: Increasing patient access without increasing physician hours
David L. Bronson, MD, and Richard A. Maxwell, MD

Premenstrual dysphoric disorder: A review for the treating practitioner
Gurjit Kaur, DO; Lilian Gonsalves, MD; and Holly L. Thacker, MD

Update on contraception: Benefits and risks of the new formulations
Pelin Batur, MD; Julie Elder, DO; and Mark Mayer, MD

DXA scanning to diagnose osteoporosis: Do you know what the results mean?
Bradford Richmond, MD

Culture, race, and disparities in health care
Charles S. Modlin, MD

Physician cultural competence: Cross-cultural communication improves care
Anita D. Misra-Hebert, MD

What are the key issues women face when ending hormone therapy?
Wulf H. Utian, MD, BCH, PhD

Vertebral compression fractures: Manage aggressively to prevent sequelae
Daniel J. Mazanec, MD; Alex Mompoint, MD; Vinod K. Podichetty, MD; and Amarish Potnis, MD

The HIP trial: Risedronate prevents hip fractures, but who should get therapy?
Chad L. Deal, MD

Discussing breast cancer and hormone therapy with women
Pelin Batur, MD; Holly L. Thacker, MD; and Halle C.F. Moore, MD

The case for hormone therapy: New studies that should inform the debate
Holly L. Thacker, MD
 


 

Guest Editors:
Gurjit Kaur, DO, and Holly L. Thacker, MD

Contents

Recognizing and intervening in intimate partner violence
Gurjit Kaur, DO, and Linda Herbert, LISW

New cervical cancer screening strategy: Combined Pap and HPV testing
Xian Wen Jin, MD, PhD; Kristine Zanotti, MD; and Belinda Yen-Lieberman, PhD

Cardiovascular problems and pregnancy: An approach to management
Samuel Siu, MD, and Jack M. Colman, MD

Treatment options for menopausal hot flashes
Andrea Sikon, MD, and Holly L. Thacker, MD

Shared medical appointments: Increasing patient access without increasing physician hours
David L. Bronson, MD, and Richard A. Maxwell, MD

Premenstrual dysphoric disorder: A review for the treating practitioner
Gurjit Kaur, DO; Lilian Gonsalves, MD; and Holly L. Thacker, MD

Update on contraception: Benefits and risks of the new formulations
Pelin Batur, MD; Julie Elder, DO; and Mark Mayer, MD

DXA scanning to diagnose osteoporosis: Do you know what the results mean?
Bradford Richmond, MD

Culture, race, and disparities in health care
Charles S. Modlin, MD

Physician cultural competence: Cross-cultural communication improves care
Anita D. Misra-Hebert, MD

What are the key issues women face when ending hormone therapy?
Wulf H. Utian, MD, BCH, PhD

Vertebral compression fractures: Manage aggressively to prevent sequelae
Daniel J. Mazanec, MD; Alex Mompoint, MD; Vinod K. Podichetty, MD; and Amarish Potnis, MD

The HIP trial: Risedronate prevents hip fractures, but who should get therapy?
Chad L. Deal, MD

Discussing breast cancer and hormone therapy with women
Pelin Batur, MD; Holly L. Thacker, MD; and Halle C.F. Moore, MD

The case for hormone therapy: New studies that should inform the debate
Holly L. Thacker, MD
 


 

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Peer-reviewers for 2004

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High-dose zafirlukast in emergency department provides small benefit in acute asthma

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A high dose of zafirlukast (Accolate) slightly reduces the number of patients who have an extended stay in the emergency department (number needed to treat [NNT]=20). Continuing zafirlukast at a dose of 20 mg twice a day slightly improves outpatient outcomes, as well (NNT=20 to prevent relapse).

Other studies have shown that inhaled corticosteroids are better long-term monotherapy for patients with asthma than leukotriene inhibitors. It is difficult to say whether this approach should be widely adopted—although the results are intriguing, I’d like to see at least one confirmatory study. This approach is, however, simple and relatively inexpensive. (LOE=1b)

 
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A high dose of zafirlukast (Accolate) slightly reduces the number of patients who have an extended stay in the emergency department (number needed to treat [NNT]=20). Continuing zafirlukast at a dose of 20 mg twice a day slightly improves outpatient outcomes, as well (NNT=20 to prevent relapse).

Other studies have shown that inhaled corticosteroids are better long-term monotherapy for patients with asthma than leukotriene inhibitors. It is difficult to say whether this approach should be widely adopted—although the results are intriguing, I’d like to see at least one confirmatory study. This approach is, however, simple and relatively inexpensive. (LOE=1b)

 
Bottom Line

A high dose of zafirlukast (Accolate) slightly reduces the number of patients who have an extended stay in the emergency department (number needed to treat [NNT]=20). Continuing zafirlukast at a dose of 20 mg twice a day slightly improves outpatient outcomes, as well (NNT=20 to prevent relapse).

Other studies have shown that inhaled corticosteroids are better long-term monotherapy for patients with asthma than leukotriene inhibitors. It is difficult to say whether this approach should be widely adopted—although the results are intriguing, I’d like to see at least one confirmatory study. This approach is, however, simple and relatively inexpensive. (LOE=1b)

 
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False-positive PSA associated with increased worry and fears

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False-positive results of screening tests are not benign; they have a psychological cost. Men who received false-positive PSA test results reported having thought and worried more about prostate cancer despite receiving a negative follow-up (prostate biopsy) result. They also think that the false-positive result makes them more likely to develop prostate cancer. Screening can be bad for our patients’ mental health. (Level of evidence [LOE]=1b)

 
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False-positive results of screening tests are not benign; they have a psychological cost. Men who received false-positive PSA test results reported having thought and worried more about prostate cancer despite receiving a negative follow-up (prostate biopsy) result. They also think that the false-positive result makes them more likely to develop prostate cancer. Screening can be bad for our patients’ mental health. (Level of evidence [LOE]=1b)

 
Bottom Line

False-positive results of screening tests are not benign; they have a psychological cost. Men who received false-positive PSA test results reported having thought and worried more about prostate cancer despite receiving a negative follow-up (prostate biopsy) result. They also think that the false-positive result makes them more likely to develop prostate cancer. Screening can be bad for our patients’ mental health. (Level of evidence [LOE]=1b)

 
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The authors reply: Shared appointments can be good care

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David L. Bronson, MD
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Management of erectile dysfunction by the primary care physician

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'Thanks for sharing': A fictional reflection on shared medical appointments

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The Stepwise Approach to the Treatment of Melasma

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A Review of Clinical Experience and Recommendations for Improving Patient Care (Cutis. 2005;75[suppl 2]:32-39)

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