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Based on their review of prior published studies of telemedicine ICUs and the initiation of a telemedicine ICU in a Veterans Health Administration hospital system, the authors find that costs of implementation are substantial and the sum impact on hospital expenses and profits remains unclear.
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The risk of interrupting prophylactic warfarin for stroke prevention in atrial fibrillation (AF) patients is unclear. Thus, these investigators from Denmark evaluated their national health registry and found 102,591 patients > age 30 with a first-time hospitalization for AF between 1997 and 2008.
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Pediatric stroke remains one of the top 10 causes of death in children, with a mortality rate of 0.6 deaths per 100,000 strokes, and almost all of those affected have a residual neurologic deficit.
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Managing chronic pain is a challenge for patients and clinicians alike, with 52% of chronic pain patients being treated solely by their primary care physician.1 Chronic myofascial pain affects 116 million American adults, which is more than heart disease, cancer, and diabetes combined.2
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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.
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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.
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