Thrombus - 1999

Thrombosis in sickle cell disease
Antonio Almeida and Sally Davies
pp 1-4
Sickle cell disease (SCD) is one of the most common haemoglobinopathies in Britain, affecting approximately 175 live births every year in England. It is caused by a point mutation that leads to the substitution of valine for glutamic acid at position 6 of the beta chain, thus forming a structural haemoglobin variant, HbS. The affected individuals are either homozygous for HbS or compound heterozygotes for HbS together with other beta chain variants, such as beta thalassaemia (betaO or beta+), HbC, HbDPunjab and HbE.
Comment: DVT treatment – the primary care case
David Fitzmaurice
pp 2-2
In the last issue of Thrombus (1999; 3(2): 2) Dr Rose argued for the retention of responsibility for DVT treatment within the hospital sector, despite the fact that the only real function of the hospital within the model proposed is to establish a diagnosis. Let us look at the arguments.
Near-patient INR measurement – a review of three systems
E T Murray and David Fitzmaurice
pp 5-7
Several near-patient testing (NPT) systems are available for INR estimation. These afford the possibility of devolved INR measurement outside the hospital laboratory – for example, in primary care or even for patients to measure their own INR. Given the difficulties already established with laboratory standardisation of INR measurement, it is essential that NPT for INR measurement is evaluated within the area in which it is to be used. Three NPT devices – Protime™ (ITC Technidyne), Coaguchek™ (Boehringer Mannheim) and TAS™ (DTL Diagnostic Testing Ltd) have been shown to be reliable in comparison with standard laboratory INR techniques within a controlled laboratory environment.
Air travel and venous thrombosis
Patrick Kesteven and Brian Robinson
pp 8-9
Reports of an association between commercial air travel and venous thromboembolic disease (VTE) have been appearing for over 40 years. Media attention became focused when the term ‘economy class syndrome’ was coined in 1988. This term may be misleading as there is no evidence (for or against) to suggest that VTE occurs more commonly in economy class. Indeed, there have been some well-publicised cases recently of pulmonary embolism following flights in first class. The term ‘travellers’ thrombosis’ may be more appropriate.
Developing a haemostasis link nurse service
Steve Davidson
pp 10-11
As the pressure increases to develop the role of haemostasis specialist nurses, and the number of anticoagulated patients spirals upward, how can we find the time to ensure that the needs of our client group are being met effectively during hospitalisation? This article identifies a strategy created to promote the collaboration between clinical practice and our specialty with an aim of developing medical and nursing knowledge of the coordination and discharge planning of anticoagulated patients.

Thrombus was previously supported by Bayer from 2014 to 2016, by Boehringer Ingelheim from 2009 to 2013, by sanofi-aventis from 2007 to 2008 and by Leo Pharma from 1998 to 2006.

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ISSN 1369-8117 (Print)  ISSN 2045-7855 (Online)