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Is There a Role for Vitamin K Antagonist in the Management of Atrial Fibrillation in 2023?
AbstractPurpose of ReviewTo address the following question: Are vitamin K antagonists (VKA) obsolete as stroke prevention therapy for patients with atrial fibrillation (AF) and thromboembolic risk factors?Recent FindingsA patient-level meta-analysis of the pivotal phase III randomized trials confirmed the favorable treatment effect of direct oral anticoagulants (DOAC) over VKA in multiple key patient subgroups. Among patients with AF and rheumatic heart disease (85% of whom had mitral stenosis), a randomized trial showed that rivaroxaban was not superior to VKA for stroke prevention. Caution should be exercised when prescr...
Source: Current Cardiology Reports - March 30, 2023 Category: Cardiology Source Type: research

Vitamin B12 Deficiency: Recognition and Management.
Abstract Vitamin B12 deficiency is a common cause of megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations. Screening average-risk adults for vitamin B12 deficiency is not recommended. Screening may be warranted in patients with one or more risk factors, such as gastric or small intestine resections, inflammatory bowel disease, use of metformin for more than four months, use of proton pump inhibitors or histamine H2 blockers for more than 12 months, vegans or strict vegetarians, and adults older than 75 years. Initial laboratory assessment should include a complete blood count ...
Source: American Family Physician - September 15, 2017 Category: Primary Care Authors: Langan RC, Goodbred AJ Tags: Am Fam Physician Source Type: research

Pre-operative evaluation in obstructive sleep apnea patients undergoing bariatric surgery: sleep laboratory limitations
Worldwide, venous thromboembolism (VTE) is among the leading causes of death from cardiovascular disease, surpassed only by acute myocardial infarction and stroke. The spectrum of VTE presentations ranges, by degree of severity, from deep vein thrombosis to acute pulmonary thromboembolism. Treatment is based on full anticoagulation of the patients. For many decades, it has been known that anticoagulation directly affects the mortality associated with VTE. Until the beginning of this century, anticoagulant therapy was based on the use of unfractionated or low-molecular-weight heparin and vitamin K antagonists, warfarin in p...
Source: Jornal Brasileiro de Pneumologia - May 6, 2016 Category: Respiratory Medicine Source Type: research