Guidelines on lupus anticoagulant screening Ian Jennings pp 1-4 Guidelines on lupus anticoagulant (LA)
screening or testing have been regularly
published for over 25 years. This article
reviews the history of LA guidelines, and a
subsequent article will indicate what is new
in the latest guidelines, which were
published in the Journal of Thrombosis and
Haemostasis in October 2009.
Antiphospholipid syndrome (APS) is
associated with venous thromboembolic
disease, arterial occlusive events and
pregnancy morbidity.
|
Comment: Is it really as simple as ABCD? Peter Rose pp 2-2 To help stratify patients at risk of
stroke, several clinical algorithms have
been developed. These have the potential to
enable preventative measures to be set in place
to reduce stroke events and also to identify
patients likely to have the most serious
outcomes. Triaging the appropriate patients
with transient ischaemic attacks (TIAs) for more
interventions is an equally important
consideration. Atrial fibrillation (AF) is well
known to be associated with cardiovascular
disease and adverse stroke outcomes.
|
Update on the management of acute venous thromboembolism Martin Lewis and Jennie Wimperis pp 5-7 Acute venous thromboembolism (VTE)
has an annual incidence of
approximately one to two per 1,000 in
adults and is the third most common
cause of vascular mortality after
myocardial infarction and stroke. The
House of Commons Health Committee
reported in 2005 that, every year, an
estimated 25,000 people in the UK die
from preventable hospital-acquired VTE,
making this the leading cause of
preventable inpatient mortality.
|
Evidence against low molecular weight heparin for superficial thrombophlebitis Louise Fryearson pp 8-9 Superficial thrombophlebitis (ST) usually
comprises pain, localised erythema and
swelling, and is commonly associated
with varicose veins. Superficial venous
thrombosis (SVT) may be a consequence
of ST, and the terms are used
interchangeably throughout the
literature. ST is often considered a
benign and self-limiting condition.
Patient presentation to healthcare
professionals is highly variable and,
consequently, there is no clear incidence
data for this condition.
|
Accuracy of prescribing therapeutic doses of enoxaparin Uttamlal Chouhan, Matthew Bevan and Jillian Simpson pp 10-11 The various forms of low molecular
weight heparin (LMWH) are now the
heparin of choice for the treatment of
venous thromboembolism (VTE) and
acute coronary syndrome (ACS),
replacing the previously routine use of
unfractionated heparin (UFH). Treatment
for both VTE and ACS is initiated as an
emergency by junior medical staff in
training. There is developing evidence for
the poor accuracy of prescribing of
LMWH in hospital practice.
|
A nurse-led approach to risk assessment Adam Howard and James AG Madden pp 12-15 Venous thromboembolism (VTE) – incorporating pulmonary embolism (PE) and deep vein thrombosis (DVT) – is one of the most common complications of hospitalisation, leading to mortality, a short- and long-term increase in morbidity and increased costs. VTE is responsible for an estimated 24,000–32,000 deaths a year in the UK, with the majority of fatal PE occurring in non-surgical patients. There has been extensive evidence presented in literature over the last 50 years to suggest that the use of thromboprophylaxis is cheap, effective and safe, with significant reductions in the number of cases of PE and DVT.
|