PT/INR Testing

Coag-Sense: PT/INR Results for Medical ProfessionalsTwo million new people start taking the oral anticoagulant drug Coumadin (also known generically as warfarin) every year to prevent blood clots, heart attacks and stroke. Dosing of warfarin is complicated by the fact that it interacts with many commonly used medications and even with chemicals that may be present in certain foods. These interactions may enhance or reduce warfarin’s anticoagulation effect. In order to optimize the therapeutic effect without risking dangerous side effects such as bleeding, close monitoring of the degree of anti-coagulation is required by blood testing.

Correct dosing of warfarin is determined for each patient by periodically measuring blood clotting time using the prothrombin time or, as it’s commonly called, the PT test. The new Coag-Sense system offers clinicians a PT test with simplicity, performance, and reliability. The portable system is CLIA waived for physician office labs, and unlike electrochemical detection based devices, the Coag-Sense system does not rely on the concentration of blood constituents not involved in clot formation to produce results. This improves precision and reduces variability in readings often seen in other systems. The results of the Coag-Sense are comparable to gold standard WHO tilt-tube method.

The Coag-Sense meter directly measures the prothrombin time, so the time required to perform a test is the actual prothrombin time in seconds. There is no need for tables or curve-fitting algorithms— the Coag-Sense meter offers both speed and accuracy.

The Coag-Sense System is available exclusively through a network of qualified distributors, which includes QuickMedical. Contact us today and a trained product specialist will assist you in purchasing and setting up your Coag-Sense system.

md-admissions
Another reason why Coag-Sense  PT/INR tests are important!
mynotes4usmle:

WARFARIN-INDUCED SKIN NECROSIS
Warfarin necrosis usually occurs three to five days after drug therapy is begun, and a high initial dose increases the risk of its development.[3]:122 Heparin-induced necrosis can develop both at sites of localinjection and - when infused intravenously - in a widespread pattern.[3]:123
In warfarin’s initial stages of action, inhibition of protein C and Factor VII is stronger than inhibition of the other vitamin K-dependent coagulation factors II, IX and X. This results from the fact that these proteins have different half-lives: 1.5 to six hours for factor VII and eight hours for protein C, versus one day for factor IX, two days for factor X and two to five days for factor II. The larger the initial dose of vitamin K-antagonist, the more pronounced these differences are. This coagulation factor imbalance leads to paradoxical activation of coagulation, resulting in a hypercoagulable state and thrombosis. The blood clots interrupt the blood supply to the skin, causing necrosis. Protein C is an innate anticoagulant, and as warfarin further decreases protein C levels, it can lead to massive thrombosis with necrosis and gangrene of limbs.
Notably, the prothrombin time (or international normalized ratio, INR) used to test the effect of coumarins is highly dependent on factor VII, which explains why patients can have a therapeutic INR (indicating good anticoagulant effect) but still be in a hypercoagulable state.[1]
In one third of cases, warfarin necrosis occurs in patients with an underlying, innate and previously unknown deficiency of protein C. The condition is related to purpura fulminans, a complication in infants with sepsis (blood stream infection) which also involves skin necrosis. These infants often have protein C deficiency as well. There have also been cases in patients with other deficiency, including protein S deficiency,[6][7] activated protein C resistance (Factor V Leiden)[8] and antithrombin III deficiency.[9]
Although the above theory is the most commonly accepted theory, others believe that it is a hypersensitivity reaction or a direct toxic effect.[1]

Another reason why Coag-Sense  PT/INR tests are important!

mynotes4usmle:

WARFARIN-INDUCED SKIN NECROSIS

Warfarin necrosis usually occurs three to five days after drug therapy is begun, and a high initial dose increases the risk of its development.[3]:122 Heparin-induced necrosis can develop both at sites of localinjection and - when infused intravenously - in a widespread pattern.[3]:123

In warfarin’s initial stages of action, inhibition of protein C and Factor VII is stronger than inhibition of the other vitamin K-dependent coagulation factors IIIX and X. This results from the fact that these proteins have different half-lives: 1.5 to six hours for factor VII and eight hours for protein C, versus one day for factor IX, two days for factor X and two to five days for factor II. The larger the initial dose of vitamin K-antagonist, the more pronounced these differences are. This coagulation factor imbalance leads to paradoxical activation of coagulation, resulting in a hypercoagulable state and thrombosis. The blood clots interrupt the blood supply to the skin, causing necrosis. Protein C is an innate anticoagulant, and as warfarin further decreases protein C levels, it can lead to massive thrombosis with necrosis and gangrene of limbs.

Notably, the prothrombin time (or international normalized ratio, INR) used to test the effect of coumarins is highly dependent on factor VII, which explains why patients can have a therapeutic INR (indicating good anticoagulant effect) but still be in a hypercoagulable state.[1]

In one third of cases, warfarin necrosis occurs in patients with an underlying, innate and previously unknown deficiency of protein C. The condition is related to purpura fulminans, a complication in infants with sepsis (blood stream infection) which also involves skin necrosis. These infants often have protein C deficiency as well. There have also been cases in patients with other deficiency, including protein S deficiency,[6][7] activated protein C resistance (Factor V Leiden)[8] and antithrombin III deficiency.[9]

Although the above theory is the most commonly accepted theory, others believe that it is a hypersensitivity reaction or a direct toxic effect.[1]

What’s Up with This Picture?

It takes a pretty rare picture to be worth a whole blog. And maybe this picture isn’t really worth the entire blog. But maybe it is. We found this bizarre picture of an echocardiogram in progress, on WebMD to share with you. 

A Picture is Worth 300 Words
Who knew an Echocardiogram could be this sexy?

This picture is really strange. What’s the context? We found it on WebMD as part of a listicle slideshow about heart health. Pretty boring stuff, honestly, and then we clicked and— wow! Almost not safe work. Both patient and doctor are so serious looking, but that patient’s mustache telegraphs he’s ready to party once he gets up and out of that Gendron Bariatric Acute Care Bed. The red lighting gives the scene the flair of the old Storyville section of New Orleans. I can almost hear the clarinets.

Another weird thing about the picture is that the patient on first glance appears to be holding the medical stethoscope to his own chest. On closer inspection, I think it is the doctor’s hand, actually— but she has really big hands.

Finally, what’s most off-putting about the picture is the patient’s position. He’s reclining like a Roman aristocrat at a feast in an Italian gladiator movie. Yes, you have to lay sideways when you get an Echocardiogram, but do you have to do it like a satyr waiting for grapes to drop from the sky?

All joking aside, while we don’t carry echocardiogram technology at QuickMedical, we do have a a groundbreaking portable EKG monitor as well as professional supplies and equipment needed for EKG assessment. Electrocardiogram technology is essential for diagnosing and evaluating heart rhythm.

Cardiovascular health is extremely important. Heart disease is the leading cause of death in the USA. If you need an electrocardiogram it’s probably not a laughing matter. But, someone did say laughter was the best medicine, so check your blood pressureregularly, watch your diet, get regular exercise, and don’t take things too seriously.

QuickMedical, your online medical supply store, has thousands of medical products, including professional medical equipment, disposable medical supplies, fitness and therapy products, along with a full line of home healthcare products.

But we’re not just another online retailer.

What’s the QuickMedical difference? The difference is the QuickMedical experience, provided by our staff. The difference is our commitment to innovation and customer service.

New at QuickMedical: The Wolf X-Ray 61100 Apron Caddy

Wolf X-Ray 61100 Apron Caddy

The Wolf X-Ray 61100 Apron Caddy protects and safely transports x-ray aprons without damaging the apron’s internal x-ray protective lining, increasing its usable life. The Apron Caddy fits one rolled up adult x-ray apron and features a carry handle, shoulder strap, and convenient outer pocket. 

Prevent Skin Cancer

What is SPF?

Skin cancer detection month ended in May, but that doesn’t mean it’s time to stop being wary of the dangers of skin cancer. Taking good care of your skin is vital during the bright sunny days of summer. Yahoo health reports, “according to the Skin Cancer Foundation, adults who use sunscreen with SPF 16 and above can cut their risk of developing melanoma, the deadliest form of skin cancer, in half.”

Using sunscreen and using it properly is vital in protecting yourself from skin cancer. Consumer Reports found that unfortunately many sunscreens don’t actually provide the SPF they promise when they come into contact with water. In fact the FDA has limited the use of the term “waterproof” on many sunscreen products. What is SPF and how do you find a high SPF sunscreen? Click ahead for more information on this common term.

SPF stands for sun protection factor. It is an imperfect measurement. According to the UCSF school of medicine, the SPF rating is a measure of “how long a sunscreen remains effective on the skin.” The effectiveness of a sun block can be determined “by multiplying the SPF factor by the length of time it takes for him or her to suffer a burn without sunscreen.” Thus, if a person develops a sunburn in 10 minutes when not wearing a sun block, the same person will prevent sunburn for 150 minutes if he/she wears a sun block with a SPF of 15. Consequently, SPF 100 is not twice as strong as SPF 50— it’s about 1% as strong.

With this information it’s important to use a high SPF, and follow all directions associated with use to adequately protect your skin from the sun. But that’s not all you can do. The Skin Cancer Foundation recommends that everyone do a monthly self-examination of their skin to look for any changing or new lesions. These may be early-stage skin cancer, and can be easily removed and therefore easy to prevent.

Unfortunately invisible damage and skin aging are also caused by ultraviolet light which does not cause skin reddening or pain. Conventional sunscreen blocks very little ultraviolet radiation relative to the SPF. UV light has been found to increase the risk of melanoma. The best and only protection for this type of sun exposure is to cover up with hats, shirts, and sleeves.

Take good care of your skin this summer, check often for early signs of melanoma, and see yourdermatologist if you have any questions or concerns.

The Taylor 1350J Mechanical Bathroom Scale, with all chrome platform and easy-to-clean premium mixed rib mat, features a capacity of 300 lbs, heavy-gauge steel construction, and a large, easy-to-read 7 inch speedometer-style dial. Other features include personal color-coded WeighTracker indicators.

http://www.quickmedical.com/taylor/mechanical-bathroom-scales/1350j-bathroom-scale.html

The Taylor 1350J Mechanical Bathroom Scale, with all chrome platform and easy-to-clean premium mixed rib mat, features a capacity of 300 lbs, heavy-gauge steel construction, and a large, easy-to-read 7 inch speedometer-style dial. Other features include personal color-coded WeighTracker indicators.

http://www.quickmedical.com/taylor/mechanical-bathroom-scales/1350j-bathroom-scale.html