Canadian family physician Médecin de famille canadien
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To examine the mortality risk presented by normal-weight central obesity, to identify a clinical measure to aid in the identification of this phenotype, and to explore the means for mitigation of this risk. ⋯ A waist-to-height ratio exceeding 0.5 at normal BMI identifies elevated mortality risk for cardiometabolic disease. This risk might equal or exceed that of centrally obese patients who are overweight or obese. Modest dietary and exercise interventions can be effective in mitigation of this risk.
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To determine the stability of warfarin anticoagulation using a nationally representative sample of Canadian primary care patients and providers. ⋯ Primary care warfarin management produces a TTR comparable to that in randomized trials, with out-of-range INR values 3 times more likely to predispose to thrombosis (INR of < 2.0) than to hemorrhage (INR of > 3.5). A history of good INR control does predict future INR stability and meaningfully informs decisions to switch established warfarin users onto newer agents.