Severe necrotic oesophageal and gastric ulceration associated with dabigatran.

A 69-year-old Caucasian man, who had been discharged 2 days previously, 5 days post-elective right total hip replacement, was re-admitted with a 16 h history of coffee-ground vomiting and epigastric pain. He had been discharged with 220 mg dabigatran, a novel oral anticoagulant. The coffee-ground vomiting started within minutes of taking the first dose.

The role of methicillin-resistant Staphylococcus aureus in orthopaedic implant surgery.

The problems presented by methicillin-resistant Staphylococcus aureus (MRSA) must be accommodated in both prophylactic and treatment regimens for orthopaedic implant surgery. The rationale of pre-admission nasal swabbing in directing prophylaxis for orthopaedic patients is discussed. The potential advantage of nasal mupirocin for Staphylococcus aureus and MRSA carriers is described.