Background: Widespread use of new oral anticoagulants (NOAG) for Atrial Fibrillation (A-Fib) has increased the annual incidence of gastrointestinal bleed (GIB) in recent years. These NOAG agents in our study include Rivaroxaban, Apixaban and Dabigatran. Convenience of use, quick onset, broad therapeutic window and eliminating need for frequent monitoring makes NOAGs attractive for A-Fib associated [...]

Background: Bridging anticoagulation is commonly prescribed to patients with atrial fibrillation who are initiating therapy or require interruption of anticoagulation for procedures. Current guidelines recommend bridging for patients at high risk of stroke, but no data guide this recommendation. Among patients with atrial fibrillation and one or more risk factors for thromboembolic stroke, the recently [...]

Background: Strategies to reverse the effect of warfarin, a vitamin K antagonist (VKA), may be necessary for patients who are actively bleeding, asymptomatic with markedly elevated INR values, or requiring urgent invasive procedures. The purpose of this quality improvement activity (QIA) was to evaluate adherence to the 2012 CHEST guidelines for use of vitamin K [...]

Case Presentation: A 21 year old male with no significant past medical or surgical history presented to the hospital with sudden onset of bilateral lower extremity paralysis and paresthesia. He was lifting heavy boxes at work when he felt severe lower back pain that eventually radiated to his legs. The pain was followed by bilateral [...]

Case Presentation: A 65 year-old man with primary antiphospholipid syndrome (APS) was transferred to our hospital for management of refractory thrombocytopenia and thrombosis. His disease was diagnosed by positive lupus anticoagulant, anti-cardiolipin antibody, beta-2-glycoprotein IgM and IgG, and was well controlled with warfarin for years. His worsening APS was precipitated by traumatic subdural hematomas and [...]