Telemedicine has the potential to revolutionize the way professionals in the field and in the office interact to treat the complex wounds of bedridden or homebound patients. If today's reimbursement environment is any indication, however, telemedicine will have a tough time making significant inroads over the course of a single decade. This does not necessarily have to be the case. Possible solutions include reimbursing telemedicine for patients with legitimate travel problems, adding a prospective payment modifier for complex wounds, and creating incentives for positive wound outcomes.
Warfarin: A multidose study of oxandrolone, given as 5 mg or 10 mg BID in 15 healthy subjects concurrently treated with warfarin, resulted in a mean increase in S-warfarin half-life from 26 to 48 hours and AUC from ng•hr/mL to ng•hr/mL; similar increases in R-warfarin half-life and AUC were also detected. Microscopic hematuria (9/15) and gingival bleeding (1/15) were also observed. A -fold decrease in the mean warfarin dose from mg/day to mg/day (approximately 80% to 85% reduction of warfarin dose), was necessary to maintain a target INR of . When oxandrolone therapy is initiated in a patient already receiving treatment with warfarin, the INR or prothrombin time (PT) should be monitored closely and the dose of warfarin adjusted as necessary until a stable target INR or PT has been achieved.