Xarelto: Now approved for DVT and PE – pro

  Xarelto (varoxaban, a factor Xa inhibitor) is the first oral anti-coagulant approved for anti-coagulation in 60 years, since Warfarin (coumadin) was approved. A variety of parenteral options are available; however, the oral route is preferred by many physicains and patients. In November 2012, the U.S. Food and Drug Administration expanded the approved use of Xarelto (rivaroxaban) to include treating deep vein thrombosis (DVT) or pulmonary

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Flexitouch System for Lymphedema – pro

Lymphedema is condition that is difficult to treat. Flexotouch is a non-manual device. Guidelines on its appropriateness are discussed. Lymphedema pumps (pneumatic compression devices) are generally considered medically necessary for home use for the treatment of lymphedema if the member has undergone a four-week trial of conservative therapy and the treating doctor determines that there has been no significant improvement or if significant symptoms

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Hypercoagulability and homocystein – pro

Hypercoagulable states can be defined as a group of inherited or acquired conditions associated with a predisposition to venous thrombosis, arterial thrombosis, or both. Venous thromboembolic disease is the most common clinical manifestation resulting from hypercoagulable states. Among them is hyperhomocysteneimia. Hyperhomocysteinemia can be precipitated by both genetic defects and acquired medical conditions, including vitamin deficiency states.

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Anticoagulation in cancer patients – guidelines – pro

Pulmonary emboli is an indication for long term anticoagulation. Although generally oral warfarin is used, it is now recognized that it is not as effective in patients with thromboses secondary to cancer as are the low molecular weight heparins, such as Lovenox. Low Molecular Weight Heparins are used for the prophylaxis or treatment of deep vein thrombosis. The decision to use LMWH instead of standard heparin or warfarin will depend upon the clinical

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Home treatment of DVT – pro

Four criteria can be used to identify patients with DVT for whom outpatient treatment might not be appropriate: presence of massive DVT, presence of symptomatic pulmonary embolism, high risk of bleeding with anticoagulant therapy, and presence of comorbid conditions or other factors that warrant in-hospital care. This is an extensively studied subject and at this point,  limited evidence suggests that home management is cost effective and preferred

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