My mother was on warfarin for a number of years and her degree of anticoagulation was difficult to manage. She had a number of complications, including bleeding episodes. So, I was enthusiastic about these new anticoagulants with their more predictable therapeutic effect. As with all new drugs, there are downsides; currently the lack of a readily available coagulation test to assess if there is a significant coagulopathy and an effective reversal agent. As these drugs are increasingly used, emergency physicians will see patients such as the three cases presented below.
Medically self-sabotaging behavior encompasses a number of diverse phenomena that include factitious disorder, making medical situations worse on purpose, and preventing wounds from healing.
Procedural sedation is an important skill for emergency physicians to possess to mitigate the patient's intense physical and emotional reactions to painful and threatening procedures.
A new androgen receptor antagonist has been approved for the treatment of late-stage prostate cancer. Enzalutamide was approved 3 months ahead of schedule due to a priority review by the FDA. The drug is comarketed by Astellas Pharma and Medivation as Xtandi.
After careful evaluation of all the published studies regarding the possible adverse effects of statin therapy, Jukema et al have concluded that there is no proven increased risk of cognitive decline or cancer development. However, there is a possible small increased risk for the development of type 2 diabetes mellitus.
