WarfarinGuide vs Dermoscopy Two Step Algorithm

Warfarin Guide offers three resources essential for systematic and careful evidence-based anticoagulation with Warfarin. First it reviews recommendations on indications, INR targets, and treatment duration from the American College of Chest Physicians 8th Edition guidelines on Antithrombotic and Thrombolytic Therapy from 2008, updated for the 2012 guideline. Second it offers a protocol for Warfarin dose adjustment depending upon INR result. And third is a discussion of protocols for the initiation of Warfarin. These resources come from point of care guides on these topics in the family medicine literature as well as the 2012 ACCP guideline. The app also offers guidance for management of peri-operative Warfarin by directing the user to oexcellent comprehensive resources for managing all anticoagulants and antiplatelet agents around surgery. The app addresses such common questions as: •which artificial heart valves require that higher level of anticoagulation? •how do I respond to an INR of 7.4? •this pt needs Warfarin, how do I get it started? •I'm adjusting the total weekly warfarin dose down by 5%, when should I recheck the INR? •when do I give Vitamin K to reverse Warfarin anticoagulation and at what dose?? This app is written and intended for practicing clinicians involved in Warfarin anticoagulation such as internists, cardiologists, family physicians, nurses, pharmacists, PA's and NP's; for resident physician trainees; and for medical students. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.

This app is intended to help you interpret the dermoscopic patterns seen with your dermatoscope. You will be asked a series of questions that will lead you to the most probable diagnosis. This app also contains over 80 photos and charts to help you in your diagnosis. No internet connection needed to view the full app. It is all ready for super quick image and information retrieval. There are also 50 interactive cases to solve. Each case starts with a clinical and dermoscopic image and ends with a labelled dermoscopic image pointing out critical structures. This app is based on the 2 step algorithm with the first step involving the determination of whether the lesion is a melanocytic. Melanocytic lesions will be divided into nevi or lesions with varying levels of suspicion for melanoma based on melanoma specific patterns and common nevi patterns. Non-melanocytic lesions will be analyzed to determine if they are suspicious for basal cell carcinoma or squamous cell carcinoma. Common benign lesions such as dermatofibroma, seborrheic keratoses and hemangiomas will be positively identified to avoid unnecessary biopsies. This app will increase your ability to detect skin cancers with greater accuracy thereby decreasing unnecessary biopsies and missing less early melanomas and nonmelanoma skin cancers. Check out https://usatinemedia.com to learn more and watch a video demo of this app narrated by Dr. Richard P. Usatine. Authors: Ashfaq A. Marghoob, MD Memorial Sloan-Kettering Cancer Center New York, New York Richard P. Usatine, MD University of Texas Health Science Center San Antonio, Texas Natalia Jaimes, MD Aurora Skin Cancer Center and Universidad Pontificia Bolivariana Medellin, Colombia To learn more dermoscopy from these authors, see www.americandermoscopy.com. Disclaimer: This app is intended for the education of healthcare professionals and not as a diagnostic and treatment reference for the general population. Disclaimer: While this app may help you in rendering a correct diagnosis, it is not intended to entirely replace the findings on patient history and physical examination including examination of the lesion with side lighting and touch. The final diagnosis rests on properly assimilating the information gained from the patient history, thorough naked eye physical examination, and meticulous dermoscopic inspection of the lesion. 3Gen, Inc. is the sponsor of this app. Visit www.dermlite.com to see their complete line of skin imaging devices. Developed by Usatine Media Richard P. Usatine, MD, Co-President, Professor of Family & Community Medicine, Professor of Dermatology and Cutaneous Surgery, University of Texas Health San Antonio Peter Erickson, Co-President, Lead Software Developer