Thrombus - 2008


Using diagnostic tests
David Fitzmaurice and Janusz Kaczorowsk
pp 1-3
Tests are part of the diagnostic process that includes history, examination and investigation. It has been suggested that within primary care the first two of these processes are most important, yielding around 90% of diagnoses. The specificity of physical signs and symptoms tends to decrease as patients move along the diagnostic pathway from primary to secondary care, as patients in primary care often present with undifferentiated symptoms and signs, at an early stage in the disease process and with a wide differential diagnosis.
Comment: The new anticoagulants cometh
Peter Rose
pp 2-2
While many in the past 40 years have foretold of forthcoming new anticoagulants it does now appear that this new era has finally arrived. The holy grail has always been well defined, namely to develop an anticoagulant that can be taken orally, that does not require laboratory monitoring, does not interact with other medications (including alcohol), with a good safety profile.
Thrombolysis-related haemorrhage: anticoagulant and antiplatelet therapy
Elizabeth A Warburton and Philip L Clatworth
pp 4-5
Stroke is the leading cause of disability in the UK, and a leading cause of death. Thrombolysis using intravenous recombinant tissue plasminogen activator (rt-PA) is the only licensed and proven therapy for acute stroke. If administered early (within three hours of symptom onset), this can reduce death and disability due to ischaemic stroke by about one-third.
Responding to thrombosis guidelines
Andrew D Blann
pp 6-8
In 2007 the government published three documents on the management of venous thromboembolism (VTE): the report of the independent expert working group (IEWG), Report 46 from the National Institute for Health and Clinical Excellence (NICE), and Alert 18 from the National Patient Safety Agency (NPSA).
Transfusion issues surrounding the use of fresh frozen plasma
Barry Hill
pp 10-11
There is no doubt that the now ready availability of blood components such as fresh frozen plasma (FFP) has made a significant contribution to the treatment of haematological bleeding disorders and management of uncontrolled bleeding during trauma situations. However, despite these proven benefits to patients, several safety issues and concerns regarding inappropriate usage, viral or bacterial transmission risks, variant Creutzfeldt–Jakob disease (vCJD) considerations and immune complications of transfusion surround their deployment.

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