Arch Intern Med
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Brodifacoum is a readily available, second-generation anticoagulant rodenticide (superwarfarin) that causes extended depletion of vitamin K1-dependent clotting factors. Brodifacoum ingestions are being reported with increasing frequency. For the first time, we compare plasma brodifacoum concentration to prothrombin levels over time in a case of brodifacoum poisoning. ⋯ Persistently increased prothrombin times necessitated treatment with phytonadione up to 80 mg/d for 4 months, until the brodifacoum level reached 10 micrograms/L. These data may help project the duration of phytonadione treatment required in future cases of brodifacoum poisoning. Superwarfarin exposure must be suspected in an otherwise unexplained vitamin K1-deficient coagulopathy.
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Tunneled central venous catheters (CVCs) and infusion ports have often been considered as the only safe alternative for long-term venous access. The objective of this study was to assess the durability, cost, and infection rate of nontunneled, noncuffed Silastic CVCs. ⋯ Given the low infection rate and long durability of nontunneled silicone CVCs, these catheters could offer a cost-effective and safe alternative to surgically implantable tunneled catheters.