We read with great interest the case by Leyh and associates on prosthetic valvular thrombosis in a pregnant patient anticoagulated with low-molecular-weight heparin (LMWH) [1]. Their case confirms once more the inefficacy of heparins to protect the mother from prosthetic valve thrombosis during pregnancy [2]. The usual management of anticoagulation in pregnant women is stopping warfarin adminis...

BACKGROUND Genetic variability among patients plays an important role in determining the dose of warfarin that should be used when oral anticoagulation is initiated, but practical methods of using genetic information have not been evaluated in a diverse and large population. We developed and used an algorithm for estimating the appropriate warfarin dose that is based on both clinical and geneti...

Warfarin is a frequently prescribed anticoagulant in rehabilitation patients. Adverse drug reactions of warfarin were reported as bleeding and cutaneous microvascular thrombosis. Major bleeding, such as intracranial hemorrhage and psoas hematoma, in patients receiving anticoagulation therapy is a rare condition, but sometimes very serious complication that can even be fatal. Patient-specific fa...

Professional Original Effective Date: October 26, 2010 Institutional Original Effective Date: November 29, 2010 Revision Date(s): May 20, 2011; February 14, 2012; February 24, 2012; January 15, 2013; March 19, 2013 Revision Date(s): May 20, 2011; February 14, 2012; February 24, 2012; January 15, 2013; March 19, 2013 Current Effective Date: October 26, 2010 Current Effective Date: November 29, 2010

The following protocol contains medical necessity criteria that apply for this service. The criteria are also applicable to services provided in the local Medicare Advantage operating area for those members, unless separate Medicare Advantage criteria are indicated. If the criteria are not met, reimbursement will be denied and the patient cannot be billed. Please note that payment for covered s...

        Apatient was admitted to the hospital because of epistaxis, ecchymoses and gum bleeding with INR of 5.5. This patient had a known case of diabetes mellitus type II, 5 years ago. The last dose of glibenclamide for managing signs and symptoms of diabetes mellitus was 20 mg/day. Her medical history also showed that last month she was diagnosed with atrial fibrillation with normal left vent...

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Warfarin is routinely monitored by assessing its pharmacologic effects on the international normalized ratio. However, having a patient with INR not responding to increasing warfarin dose mandates a direct measurement of warfarin concentrations (total and free) for better patient clinical management of warfarin therapy. Therefore, a new fully validated specific, precise and accurate ultra-perfo...