A 77-year-old woman is evaluated for frequently fluctuating INRs (<1.8 to >3.5) while taking warfarin therapy. She has undergone INR testing every 1 to 2 weeks and frequent warfarin dose adjustments. She reports a consistent dietary intake. Following a physical exam, what is the most appropriate next step in management?
1 May 2018
Three new online Maintenance of Certification modules associated with this year's annual meeting will allow attendees to focus their learning on the most needed areas, with immediate feedback available.
1 Mar 2012
A 42-year-old man arrives for three-month follow-up of a proximal right leg DVT after right tibia fracture. Thrombophilia evaluation was done, although not recommended by guidelines, and found an elevated plasma homocysteine level; genetic testing then found homozygosity for the C677T methylene tetrahydrofolate reductase (MTHFR) polymorphism. His only medication is warfarin. What is the most appropriate next step in management?
17 Jul 2018
A 62-year-old woman is evaluated during a follow-up visit for recently diagnosed stage IIIA high-grade serous ovarian cancer. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy and completed six cycles of chemotherapy with cisplatin and paclitaxel. The patient's paternal aunt was diagnosed with breast cancer at age 52 years. Following a physical exam and lab studies, what is the most appropriate test to perform next?
29 Jan 2019
New evidence-based guidelines on the management of sickle cell disease were released last week by a group of experts convened by the National Heart, Lung, and Blood Institute.
16 Sep 2014
Sickle cell patients who survive into adulthood are falling into a gap in care as they leave a pediatric practice and don't enter an adult one. A pilot program is offering medical education to patients and to clinicians.
1 Apr 2013
Two open-label randomized controlled trials assessed iron absorption in iron-depleted women.
17 Oct 2017
An expert reviewed the available drugs for patients with sickle cell disease and offered advice on how to use them.
1 Jun 2021
The Governance Committee of the American College of Physicians places in nomination candidates for College governance.
1 Nov 2021
A 19-year-old woman is seen for counseling regarding contraceptives. Medical history is unremarkable; she is nulliparous and has never taken prescription contraceptives. Her father had a pulmonary embolism at age 47 years, which was associated with arthroscopic knee surgery, and her 23-year-old sister experienced a deep venous thrombosis 3 weeks after delivering her first child. The patient does not smoke and takes no medications. Which contraceptive method would be most appropriate for this patient?
23 Jan 2018