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Jul 11 2017

Einstein Choice: Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism

EBM, Journal Club

Clinical Question In patients who would benefit from continued anti-coagulation is treatment dose rivaroxaban vs thromboprophylactic dose as effective as aspirin for prevention of recurrent thromboembolism? Bottom Line Rivaroxaban at both treatment dose (20mg) and a thromboprophylactic dose (10mg), was…

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Jun 06 2017

PESIT Trial

EBM, Journal Club

Thank you Dr. Noah Duncan for an excellent overview of the PESIT trial (Prevalence of Pulmonary Embolism among Patients Hospitalized for Syncope) Conclusions of the study: Pulmonary embolism was identified in nearly one of every 6 patients hospitalized for a…

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Mar 09 2017

BRIDGE TRIAL

EBM, Journal Club

Thank you Thomas Vu for your excellent overview of the BRIDGE trial (Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation) Conclusions of the study: In patients with atrial fibrillation who had warfarin treatment interrupted for an elective operation or other elective invasive…

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Mar 09 2017

STOPAH TRIAL

EBM, Journal Club

Thank you Quynh Vu for your excellent overview of the STOPAH trial (Prednisolone or Pentoxifylline for Alcoholic Hepatitis) Conclusions of the study: Pentoxifylline did not improve survival in patients with alcoholic hepatitis Prednisolone was associated with a reduction in 28-day…

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Jan 25 2017

Acute Esophageal Variceal Bleed

Morning Report

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Thank you Dr. Kirollos Zaki for an excellent presentation on UGIB from esophageal varices

Teaching Points

  • Management of GI bleed
    • fluids, goal hg>7, plt >50, INR<1.5.
    • protonix drip if UGIB, add octreotide drip if concern for variceal bleed
  • Endoscopy
    • variceal ligation: using banding, goal is within 12 hours
    • sclerotherapy: usueally epi is used, similar results as ligation but high rebleeding risk
  • TIPS
    • Indications: active hemorrhage despite endoscopic treatment or recurrent bleed
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