Aiming for safe anticoagulation

Article Abstract:

Two 1995 studies shed light on selecting safe doses of anticlotting drugs, however it may be advisable to continue following guidelines published by the American College of Chest Physicians (ACCP). Setting doses of these drugs is complicated because too low a dose will not prevent further arterial clotting, while too high a dose may lead to hemorrhages. One study found that patients with atrial fibrillation and a previous arterial blockage should receive a dose of anticlotting drugs that produces an international normalized ratio (INR) of coagulation between 2.0 and 3.9. Another study suggests that patients with artificial heart valves should receive a dose producing an INR between 3.0 and 4.9. The problems with the studies include a need for more subjects, the low numbers of patients on warfarin, and the consideration of clotting and hemorrhaging complications as similar. The dose ranges recommended by these studies are higher than those recommended by the ACCP. More research is essential to finding the most effective and safest dose of these drugs.

Anticoagulants (Medicine), Anticoagulants, Dosage and administration

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Acute uncomplicated urinary tract infection in women

Article Abstract:

Most women with a urinary tract infection that affects only the bladder can be treated with either trimethoprim-sulfamethoxazole or a fluoroquinolone for three days. Fluoroquinolone should only be used if the bacterium causing the infection is resistant to trimethoprim-sulfamethoxazole. Women with recurring infections should be treated for several months.

Care and treatment, Urinary tract infections, Cystitis

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Does VA health care measure up?

Article Abstract:

The Veterans' Health Administration has substantially improved the delivery and quality of care in VA hospitals since the mid-1970s. A study published in 2000 found that heart attack patients treated at VA hospitals and regular hospitals had similar one-year mortality rates.

Evaluation, Medical care, Quality management, Medical care quality, Hospitals, Veterans', Veterans' hospitals

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