Highlights of this issue

Drug interactions with warfarin

Delaney and colleagues document a 4–6-fold increase in the rate of gastrointestinal hemorrhage associated with the combined use of warfarin and antiplatelet agents. This real-world study of prescription data from general practices observed much higher rates of bleeding than those derived from a meta-analysis of randomized clinical trials. A commentary by Juurlink explains the main drug interactions with the anticoagulant warfarin. Also in this issue, Hughes and coauthors report a case that illustrates how protease inhibitors can affect warfarin metabolization.

See pages 347, 357 and 369

Cesarean delivery and obstetrician type

Abenhaim and coauthors note a small but significant increase in the rate of cesarean sections when women are cared for by on-call obstetricians rather than their regular-care obstetricians. In a related commentary, Bell and Ray highlight the importance of ensuring smooth hand-offs between physicians.

See pages 352 and 372

Urinary proteomics: present and future

Urinalysis underpins the routine assessment of patients. Current methods of assessing urinary protein excretion do not discriminate between different forms of renal and extrarenal disease, but innovative urine proteomic studies are identifying novel urine proteins that may prove useful for diagnosis and monitoring of both renal and systemic diseases. Barratt and Topham summarize currently available methods for urinary protein analysis and describe newer approaches to identifying urinary biomarkers.

See page 361

Practice

Two case reports of acquired hemophilia A illustrate some of the challenges in managing this rare condition (page 339, page 341).

In Clinical Vistas, Leung and colleagues alert physicians to the symptoms of tungiasis in returning travellers (page 343).