August 29 WeeklyUpdate

Not as much content this week due to quiz bowl and ethics case rounds, but the following articles are very good reading:

From Monday's noon conference on endocarditis, I recommend this condensed article from NEJM that covers what you need to know about endocarditis for board purposes.

Friday morning report covered management of acute ischemic stroke, as well as measures to prevent recurrences.  Good articles covering the topic are below:

Acute Ischemic Stroke (NEJM Clinical Practice)

Secondary Prevention After Ischemic Stroke (NEJM Clinical Practice)

On a related note, the question often arises - should we heparin bridge A-fib patients on warfarin therapy when their medication is held for surgical procedures.  The answer, according to a study in this week's NEJM, is no.  Stroke events are not reduced, and bleeding is increased if heparin is used during the time warfarin is held.  Always pay attention to exclusion criteria, as this trial excluded anyone who had experienced stroke or TIA symptoms within 12 weeks.