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The article presents a study which investigates the prescribing habits of physicians. Result shows that physicians do not follow recommendations for dose adjustment of renally excreted medications based on two models such as prescribing habits and the use of logistic regression estimates. Result of the study suggests that physician should consider evaluating current medications and establishing a baseline for renal function and degree of decline.

Objectives: Despite evidence supporting anticoagulant use in atrial fibrillation, this modality is not fully utilized. Methods: Retrospective chart review of 297 patients with nonvalvular atrial fibrillation between 1997 to 2000. 124 patients received warfarin and 166 did not; 91 patients suffered stroke. Results: Age (P = 0.232) and gender (P = 0.745) were not determinant factors for starting anticoagulation prophylaxis. Whites were more likely to receive anticoagulation therapy than blacks (P = 0.043). Cardiologists were 4.5 times more likely to prescribe warfarin than neurologists and internists (P = 0.035). Neurologists (P = 0.305) and internists (P = 0.770) had similar warfarin prescription patterns and often with patients experiencing the highest rates of stroke. Conclusion: Lack of a uniform pattern in anticoagulant administration, despite multiple guidelines, is disturbing. Continuous physician education and community awareness by local and federal medical agencies is essential and cost-effective. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the usefulness of lactate and C-reactive protein as early markers of acute myocardial infarction (AMI) in conjunction with established markers, such as creatine phosphokinase (CPK)-MB and troponin I. Methods: The study population consisted of all patients admitted with suspected AMI regardless of age, race, gender, or comorbid conditions. All patients in cardiac heart failure or cardiogenic shock were excluded. Lactate and C-reactive protein were drawn at admission, and then at 2 and 4 hours, respectively. The positive and negative predictive values of these markers were calculated in relation to the primary outcome measure. Results: A total of 62 patients were enrolled in the study. Of those, 18 patients had documented AMI and all underwent thrombolysis, thrombolysis with angioplasty, or stent placement. The lactate was measured at 2 and 4 hours, and lactate levels correlated with CPK and CPK-MB, in addition to troponin I. In out cohort, lactate had a sensitivity of 75% and a specificity of 95.5%, with a positive predictive value of 85.7% and a negative predictive value of 91.3%. Conclusion: As an inexpensive and readily available marker for AMI, lactate seems to be reliable and could be used in an emergency setting to facilitate the decision-making process for chest pain syndrome. It would be a helpful adjunct on whether the patient can be safely discharged or should be promptly admitted. [ABSTRACT FROM AUTHOR]

Copyright of Southern Medical Journal is the property of Lippincott Williams & Wilkins and Its content may not be copied or emailed to multiple sites or posted to a listserv without the Copyright holder's express written permission. [Extracted from the article]

Abnormal Neuroimaging Study in Patients with Alzheimer's Disease. Copyright of Southern Medical Journal is the property of Lippincott Williams & Wilkins and Copyright holder's express written permission. [Extracted from the article]

Copyright of Southern Medical Journal is the property of Lippincott Williams & Wilkins and Its content may not be copied or emailed to multiple sites or posted to a listserv without the. [Extracted from the article]

An abstract of the article "Orthostatic Hypotension and Atenolol" by Orlando V. Fernando and colleagues is presented.