Oral factor Xa inhibitor apixaban - more effective than enoxaparin for thromboprophylaxis after knee replacement

Low-molecular-weight heparins such as enoxaparin are preferred for prevention of venous thromboembolism after major joint replacement. Apixaban, an orally active factor Xa inhibitor, might be as effective, have lower bleeding risk, and be easier to use than is enoxaparin.

The primary outcome in this Lancet study was the composite of asymptomatic and symptomatic deep vein thrombosis (DVT), non-fatal pulmonary embolism (PE), and all-cause death during treatment. The primary outcome was reported in 15% of apixaban patients and 24% of enoxaparin patients (relative risk 0·62), absolute risk reduction 9·3%.

Major or clinically relevant non-major bleeding occurred in 4% of patients receiving apixaban and 5% of treated with enoxaparin.

The authors concluded that apixaban 2·5 mg twice daily, starting on the morning after total knee replacement, offers a convenient and more effective orally administered alternative to 40 mg per day enoxaparin, without increased bleeding.

References:

Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. The Lancet, Volume 375, Issue 9717, Pages 807 - 815, 6 March 2010.

Image source: Apixaban, Wikipedia, public domain.

Are Almonds a Good Source of Calcium?

Over all, you would still get some calcium by eating almonds, but at a lot higher calorie cost than from other foods, like milk.

The amount of calcium in a cup of whole almonds, 378 milligrams, is slightly more than in a cup of milk, about 300 milligrams, but you would be consuming about eight times as many calories.

References:
Q and A - Almonds for Calcium? - Question - NYTimes.com.

Video: Heart Disease Myths Dispelled by a Cleveland Clinic Cardiologist

Cleveland Clinic — May 14, 2010 — Dr. Rimmerman, cardiologist and author of "The Cleveland Clinic Guide to Speaking With Your Cardiologist,"dispels common myths regarding heart disease.

Misconceptions about medical blogs

From the newsletter Australian Pharmacists:

"At the heart of social media is the blog, an online diary where news, gossip, industry issues, opinion and scandal jostle for space."

I cover medical news from educational perspective on CasesBlog but I try not to include "gossip, industry issues, opinion and scandal" and with one post per day, they never "jostle for space".

There are many different types of medical blogs, of course.

Image source: public domain.

Health Benefits of Pets - Mayo Clinic Video

May 10, 2010 — Health Benefits of Pets.

People will do a lot for their pets - see below:

- Somebody found a solution: Smokers are motivated to quit to protect their pets from secondhand smoke http://is.gd/iZ58

- "Do it for Fido: smokers may quit smoking because of their pet" http://is.gd/iZtQ

Gendercide or the worldwide war on baby girls

From The Economist:

"Gendercide" is often seen as an unintended consequence of China’s one-child policy, or as a product of poverty or ignorance. The surplus of bachelors—called in China guanggun, or “bare branches”— seems to have accelerated between 1990 and 2005, in ways not obviously linked to the one-child policy, which was introduced in 1979. And, as is becoming clear, the war against baby girls is not confined to China.

The use of sex-selective abortion was banned in India in 1994 and in China in 1995. It is illegal in most countries. But since it is almost impossible to prove that an abortion has been carried out for reasons of sex selection, the practice remains widespread. An ultrasound scan costs about $12, which is within the scope of many—perhaps most—Chinese and Indian families. In one hospital in Punjab, in northern India, the only girls born after a round of ultrasound scans had been mistakenly identified as boys, or else had a male twin.

References:

Gendercide: The worldwide war on baby girls. The Economist.

Image source: Wikipedia, GNU Free Documentation License.

How Twitter Brings Patients to Mayo Clinic

From Mayo Clinic: May 11, 2010 — People use Twitter to share information: The latest news, current events, what people are talking about, even what's for dinner. Now, people are using it to get access to health care. Last year Mayo Clinic teamed up with USA today and scheduled a Twitter chat about a painful wrist injury. Today a woman who joined that chat is pain free.

If you work for Mayo Clinic, social media is not an option, it's a job requirement http://bit.ly/IHf3lM - Others will follow.

Cleveland Clinic is also active on Twitter by asking staff to participate in scheduled chats with patients on a variety of health topics.

See an example here: Heart numbers to know - by Cleveland Clinic

Here is how to facilitate the Rise of the ePhysican who works hand in hand with the ePatient:



Related reading:

Erin Turner's Mayo Clinic e-Patient Success Story

How Should Hospitals Use Twitter? This Twitter discussion in 2008 prompted @EdBennett to start his world-famous list.

Top U.S. Hospitals Are On Twitter

Social media in medicine: How to be a Twitter rockstar and help your patients and your practice