Unfractionated heparin anticoagulation using estimated blood volume based dosing versus weight-based dosing in a Veteran population.

Objective: The purpose of this study is to compare estimated blood volume (EBV) versus weight-based (WB) dosing of unfractionated heparin in terms of safety and ability to achieve therapeutic antifactor-Xa (AF-Xa) levels.

Methods: This was a retrospective, cohort study including 32 male veterans who received UFH. Primary outcome measures included time until therapeutic anticoagulation, number of adjustments needed to achieve therapeutic anticoagulation, median AF-Xa levels and the percentage of patients who were therapeutic after the first and second levels.

A rare cause of blindness.

Background: Mycobacterium tuberculosis (TB) infection remains a serious problem in many underdeveloped countries. TB is largely perceived as a disease affecting the pulmonary system, yet despite declining cases of pulmonary TB in the United States (US), extrapulmonary infections are being reported at an increasing proportion of total TB cases. Moreover, due to the insidious nature of extrapulmonary TB (EPTB), it may not be readily recognized by emergency physicians, as it masquerades as more commonly encountered infectious or inflammatory processes.

Life-threatening hypoglycemia associated with intentional insulin ingestion.

There are reports of insulin overdose by injection, yet little is known regarding the potential harms of intentional oral ingestion of insulin. In this report, we describe a case of massive insulin ingestion and ensuing hypoglycemia. To our knowledge, there are no previously published cases of hypoglycemia caused by intentional insulin ingestion.

Clinical experience with ranolazine in a veteran population with chronic stable angina.

Background: Efficacy of ranolazine in the treatment of chronic stable angina (CSA) has been established; however, pivotal trials did not require the optimization of conventional antianginal drug therapy (CADT) prior to use in a veteran population.

Objective: To determine whether ranolazine, when added to optimized doses of CADT, improves angina in a veteran population with CSA and refractory symptoms.

Methods: In an observational retrospective study, 35 patients prescribed ranolazine and having a baseline Seattle Angina Questionnaire (SAQ) administered at a Veterans Affairs medical center in Gainesville, FL, were evaluated.