Archives of Internal Medicine

Journal Information
ISSN / EISSN : 0730188X / 15383679
Current Publisher: American Medical Association (AMA) (10.1001)
Total articles ≅ 41,413
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Archives of Internal Medicine, Volume 172; doi:10.1001/archinte.172.22.1699

Archives of Internal Medicine, Volume 172; doi:10.1001/archinternmed.2011.1007

Mitchell H. Katz
Archives of Internal Medicine, Volume 172, pp 1758-1758; doi:10.1001/2013.jamainternmed.105

The publisher has not yet granted permission to display this abstract.
Michael Hochman, Mitchell H. Katz
Archives of Internal Medicine, Volume 172, pp 1703-1704; doi:10.1001/2013.jamainternmed.117

The publisher has not yet granted permission to display this abstract.
Amit V. Khera, Samia Mora
Archives of Internal Medicine, Volume 172, pp 1710-1711; doi:10.1001/2013.jamainternmed.263

The publisher has not yet granted permission to display this abstract.
Douglas D. Decarolis, Joey G. Thorson, Megan A. Clairmont, Amy M. Leuthner, Thomas S. Rector, Gerhard J. Johnson
Archives of Internal Medicine, Volume 172, pp 1713-1718; doi:10.1001/2013.jamainternmed.369

Abstract:
Background Enoxaparin sodium has predictable pharmacokinetics that allow for simplified dosing without laboratory monitoring. Reliance on renal function for excretion may lead to accumulation of enoxaparin in patients with moderate renal impairment. However, there is no dose adjustment recommended for these patients. We conducted a review to compare bleeding events in patients with moderate renal impairment compared with those with normal renal function. Methods Patients received enoxaparin sodium, 1 mg/kg, every 12 hours or 1.5 mg/kg once daily between June 1 and November 30, 2009. Moderate renal impairment was defined as creatinine clearance (CrCl) of 30 to 50 mL/min. Normal renal function was defined as CrCl greater than 80 mL/min. The primary outcome was major bleeding, defined as any bleeding resulting in death, hospital admission, lengthened hospital stay, or an emergency department visit. The secondary outcome was thromboembolism. Results A total of 164 patients met the inclusion criteria: 105 with normal renal function and 59 with moderate renal impairment. The primary outcome occurred in 6 of 105 patients (5.7%) with normal renal function vs 13 of 59 patients (22.0%) with moderate renal impairment, representing an unadjusted odds ratio of 4.7 (95% CI, 1.7-13.0; P = .002). The odds ratio using multivariable logistic regression adjusting for differences in risk was 3.9 (95% CI, 0.97-15.6; P = .055). There was no recurrent thromboembolism in either group. Conclusions Our results suggest an increased risk of major bleeding in patients with moderate renal impairment who receive enoxaparin. Because enoxaparin is frequently used and outcomes can be life saving or life threatening, we encourage further study of the appropriate dose in patients with moderate renal impairment.
Li Zhou, Saverio M. Maviglia, Lisa M. Mahoney, Frank Chang, E. John Orav, Joseph Plasek, Laura J. Boulware, Hong Lou, David W Bates, Roberto A. Rocha
Archives of Internal Medicine, Volume 172, pp 1721-1728; doi:10.1001/2013.jamainternmed.438

Abstract:
Acetaminophen is one of the most commonly used drugs for pain relief and fever reduction.1-3 At the same time, acetaminophen toxicity is the leading cause of acute liver failure (ALF).4-7 A study of 22 specialty medical centers in the United States reported that the annual percentage of acetaminophen-related ALF rose from 28% in 1998 to 51% in 2003.4 Patients who took more than the recommended maximum dose (eg, 4 g/d for persons >12 years) of acetaminophen-containing products or who consumed alcohol while taking acetaminophen were at risk for hepatotoxicity, ranging from abnormalities in liver function blood tests,8 to ALF, and even death.9,10 Other complications include coagulopathy10 and deafness.11 The US Food and Drug Administration (FDA) has taken several steps to cut risks from acetaminophen, including asking manufactures of prescription acetaminophen combination products to limit the amount of acetaminophen to 325 mg per dosage unit and requiring a boxed warning on all products that highlights the potential risk for severe liver injury.2,12
Tracy Minichiello
Archives of Internal Medicine, Volume 172, pp 1718-1720; doi:10.1001/2013.jamainternmed.456

The publisher has not yet granted permission to display this abstract.
Shreya Kangovi, Judith A. Long, Ezekiel Emanuel
Archives of Internal Medicine, Volume 172, pp 1756-1757; doi:10.1001/2013.jamainternmed.82

The publisher has not yet granted permission to display this abstract.
Davinder Sidhu, Christopher Naugler
Archives of Internal Medicine, Volume 172, pp 1707-1710; doi:10.1001/archinternmed.2012.3708

The publisher has not yet granted permission to display this abstract.
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