Internal medicine journal
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Internal medicine journal · Feb 2017
Case ReportsProlongation of prothrombin time in the presence of rivaroxaban: is this the only cause?
Rivaroxaban is an oral direct Xa inhibitor that can lead to prolongation of prothrombin time and activated partial thromboplastin time. However, these basic coagulation tests are not specific for the anticoagulant effect of rivaroxaban and other confounding factors should be considered while interpreting the test results. We report a case of a patient on rivaroxaban, where underlying factor VII deficiency led to confusion in the interpretation of prothrombin time results and delayed her surgery.
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Internal medicine journal · Feb 2017
Comparative StudySpinal infections in older people: an analysis of demographics, presenting features, microbiology and outcomes.
Clinical features of infection can become more atypical as we age. Spinal infections can be insidious, and timely diagnosis and treatment are essential to prevent adverse outcomes. ⋯ Older patients with spinal infections present later, with higher inflammatory markers and fewer typical infective symptoms and signs; these may contribute to poorer outcomes. A low threshold for promptly investigating older patients with new or worsening back pain should be set.