Issue 2

Anticoagluation Medication



Often, treatment with anticoaugluation drugs are recommended in individuals to guard against clots resulting in heart attacks and strokes. Aspirin has been advocated as a useful initial guard against these devestating diseases. Recently, however, many NSAIDS such as VIOXX and Celebrex have been shown to actually have an increase in CVA's and MI's. One theory is that ASA inhibits platelet coagulation. Any other NSAID the person may be taking interferes with the action of ASA. Thus, any NSAID will intefere with the action of ASA and result in more cardiovascular events than ASA alone. However, many of these patients suffer from pain, such as the significant pain asssociated with arthritis. If a patient is taking ASA, would you recommend any pain reliever to further decrease the pain experienced more than the action ASA itself would result in. If so, which pain reiever would you recommend in this hypothetical patient?

Case 2

What are the likely responsible organisms?






Staghorn calculi are often the result of urea producing organisms such as Klebsiella and Proteus.

Case of the Week 1

Which group of people do not get these fractures?
The fracture of the 5th metatarsal is known as a Boxer's fracture. Ironically, boxers do not often get this fracture, as they know how to land a punch.

Current Issues 1

I wanted to change this around a bit and make it a bit more accessible.

Current Issues

The USA Today rerports the sutdy of a 14 month examination of behavioral therapy versus pharmaceutical treatment here. The Journal of the American Academy of Child and Adolescent Physchiatry reports that children with ADHD often recover in a few years of treatment. Behavioral therapy or medication seem to be equally effective. A further interview with Dr. Peter Jensen reveals that the medication offered childred afflicted with ADHD may not necessarily be effective.

In primary care, we are often asked to prescribe medication for children thought to be afficted with ADHD. How do you feel about prescribing medication to treat these children?