11 August 2024
1. INR target for stroke/afib:
  • (INR) target of 2.0 to 3.0 for preventing ischemic stroke in atrial fibrillation.
2. Who can get Hep B vaccine:
  • a. The current recommendations for childhood immunizations include administering the three-dose HBV series to newborns or at age 11 to 12 years to children not previously vaccinated. The series can be started at any age, although it is recommended that preterm infants be at least 1 month of age before starting the HBV series.
  • b. Vaccination with HBV is recommended for all ages, particularly patients at high risk of contracting hepatitis B. Those at high risk include IV drug users, infants born to mothers who are HbsAg-positive, hemodialysis patients, sexually active people with multiple partners, incarcerated people, international travelers, household contacts of hepatitis B carriers, and sexual contacts of hepatitis B carriers. Patients who are getting tattoos or who share razors, toothbrushes, or body-piercing jewelry are also at risk of contracting hepatitis B. Health-care workers, daycare staff, and other people who may have exposure to body fluids also have a greater risk of contracting hepatitis B. Patients with diabetes are at increased risk of contracting HBV and it is recommended they receive the HBV series.
3. Who can get tuberculin screening:
  • a. Targeted screening for TB is usually based on the patient’s presenting with an identified risk factor. In some areas of the country, routine TB testing is part of all health maintenance visits because of an increased incidence of TB in the area.
  • b. Patients identified as being at risk are those with compromised immune systems (e.g., HIV-positive or undergoing immunosuppressive therapy or prolonged adrenocorticosteroid therapy), close contacts of patients with newly diagnosed infectious TB, injection drug users known to be HIV seronegative, foreign-born persons from high-prevalence countries, medically underserved low-income populations, and residents and staff of long-term-care facilities or prisons. All health-care providers should be screened routinely.
4. Ultimate goal of therapy for HIV:
  • (1) Reduce HIV-associated morbidity and prolong the duration and quality of survival.
  • (2) Restore and preserve immunological function.
  • (3) Achieve maximal and durable suppression of plasma HIV viral load.
  • (4) Prevent HIV transmission.
  • Maximal suppression goal: HIV RNA less than 50 copies/mL.
  • Other goals:
    • Improve quality of life.
    • Obtain maximal and durable suppression of HIV.
    • Prevent vertical HIV transmission.
    • Prolong survival.
    • Reduce HIV-related morbidity.
    • Reduce transmissibility of HIV.
    • Restore and preserve immunological function.
5. T-score and what to do:
  • T scores of less than 2.5 are the major focus of any prefracture treatment. Those patients with BMD T scores between −1.0 and −2.5 with other factors that increase fracture risk to more than 20% in 10 years are also considered for drug interventions.