Thrombus - 2000

Infection as a cause of CHD
Amarjit Sethi, John C Hogan and Sandeep Gupta
pp 1-4
Despite the recent growth in preventive strategies and cardiovascular interventions, coronary heart disease (CHD) today remains a major cause of morbidity and mortality in industrialised countries and is steadily increasing in developing countries. Traditional risk factors such as hypercholesterolaemia, smoking, hypertension and diabetes mellitus do not fully explain the extent or severity of disease in many patients. There has been increasing interest in the role of novel risk factors and, in particular, an infectious aetiology to atherosclerosis.
Comment: Laboratory tests: why do we need them?
Peter Rose
pp 2-2
Requesting tests in medicine, without considering the consequences should the result come back abnormal, is an all too frequent mistake. Having recently been referred an 18-year-old female diagnosed with autoimmune thrombocytopenic purpura (AITP) two years earlier, with no thrombotic history, the question was asked as to why she had persistent anticardiolipin antibodies. Such antibodies can be found in approximately one-third of new cases of AITP and would not normally be considered of clinical significance.
Centralising thrombophilia patient information
Steve Davidson
pp 5-6
Recently, a computer system has been developed for the Windows® 95, 98 and NT environments to promote the co-ordination of thrombophilia-related information. Its major aim is to act as an assistant during patient consultations and to aid the total care management of thrombophilia patients. The TP-Trac© Version 1.0 thrombophilia register computer application was developed in response to the need for the centralisation of information about thrombophilia patients, to make information more accessible and eventually replace the paper system currently used by the Queen’s Medical Centre, Nottingham.
Managing pregnancy and APL
Beverley J Hunt, Cathy Nelson-Piercy, Susan Bewley and Munther Khamashta
pp 7-9
The article on antiphospholipid syndrome (APS) in Thrombus 4.2 covered clinical and laboratory diagnoses and management of thrombotic disease. This article highlights the practical issues of managing APS during pregnancy. APS is a well recognised cause of a wide spectrum of pregnancy morbidity and occasional mortality. The clinical management of APS in pregnancy has been relatively poorly studied due in part to the small numbers presenting to individual units. At Guy’s & St Thomas’ Trust, a special clinic is devoted to the management of lupus and APS during pregnancy.
A review of primary care anticoagulation management
David Fitzmaurice, Ellen Murray and Jim Murray
pp 10-11
Long-term oral anticoagulant care has traditionally involved repeated attendance at a hospital anticoagulant clinic because of the need for laboratory testing, expert interpretation of the result and adjustment of warfarin dose. The existing services are now under even greater strain due to the increasing number of patients requiring long-term anticoagulation, particularly stroke prophylaxis in atrial fibrillation.

Thrombus is funded by an unrestricted educational grant from Bayer HealthCare, with no editorial input into the contents of this journal.

Thrombus was previously supported 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)