Background: Influenza vaccines are recommended for administration by the intramuscular route. However, many physicians use the subcutaneous route for patients receiving an oral anticoagulant because this route is thought to induce fewer hemorrhagic side effects. Our aim is to assess the safety of intramuscular administration of influenza vaccine in patients on oral anticoagulation therapy.

1 Thromboembolic disease (TED) is an important cause of in-hospital morbidity and mortality. Although different prophylactic approaches have been shown to be effective and cost-effective, surveys have suggested that they are underused. The aim of this study was to estimate the prevalence of use of TED prophylaxis in our hospitals. 2 All patients admitted on a specified day to the Internal Medicine and General Surgery wards of seven Spanish university hospitals were included in the study.

The value of heparin in the prevention of venous thromboembolism has been shown effective and safe by controlled studies. However, how these studies have influenced physicians' decisions in thrombo‐prophylaxis is not known. With the aim of evaluating the frequency and the appropriateness of prophylaxis for venous thromboembolism in our centre, we performed a cross‐sectional study on a specific day. Among 667 patients who were admitted to hospital on this day, 134 (20 per cent) were receiving heparin. This had been prescribed for the prophylaxis of venous thromboembolism to 82 (12 per cent) patients. Immobilization was the risk factor most strongly associated with prophylaxis. Prophylaxis with heparin was only used in 79 out of 444 high‐risk patients (21.6 per cent). One hundred and eighty‐three patients had been subject to major surgery and heparin was being given only to 34 of them (18.6 per cent). A wide variability in the use of prophylaxis, depending on the hospital ward, was also recorded. We conclude that prophylaxis with heparin is underused in our milieu.

No abstract

Atherosclerotic cardiovascular disease (CVD) remains the major cause of premature death in developing countries, even though CVD mortality has fallen considerably over recent decades in many countries. Low-density lipoprotein (LDL) cholesterol is an important cause of coronary heart disease. Ezetimibe is a nonstatin agent that was approved in 2003 as an adjunctive therapy in combination with statins because of its ability to decrease plasma cholesterol levels. However, during a period of 12 years, this drug has been used without evidence of any positive effect in terms of morbidity and mortality. The purpose of this review is to briefly discuss the data that seem pertinent regarding the role of ezetimibe in therapy. The precise role of ezetimibe relative to other lipid-lowering drugs is unclear. Similar reductions in LDL cholesterol can often be achieved simply by maximizing the dose of statins. Ezetimibe plus atorvastatin also produced a greater reduction in serum C-reactive protein than atorvastatin alone.