Thrombus - 2001

Validation of a software system for anticoagulant dosing in primary care
Amjid Riaz, Ellen T Murray, Professor F D Richard Hobbs and David A Fitzmaurice
pp 1-4
Increased recognition of the benefits of oral anticoagulation management in a primary care setting has led to the development of computerised decision support software (CDSS) that is specifically designed for use in the primary care environment. This article reports on a recent study, carried out at the University of Birmingham’s Department of Primary Care and General Practice, to evaluate the performance of such software, and highlights the need for rigorous evaluation of anticoagulation software before routine use is recommended.
Comment: Thrombosis and systemic lupus erythematosis
Peter Rose
pp 2-2
In the early 1960s, it became apparent that a small cohort of patients with systemic lupus erythematosis (SLE) were at increased risk of developing either arterial or venous thromboembolic disease. These patients were more likely to have a chronic biological false test for syphilis, and also to have prolonged whole blood clotting and prothrombin times. Due to the prolonged clotting times observed and the evidence of an aspecific inhibitor, this activity was referred to as the lupus anticoagulant.
The clinical impact of attendance at an oral anticoagulant management study day
David A Fitzmaurice, Ellen T Murray, Pat Marsh and Kirsten M Gee
pp 5-7
Near-patient testing (NPT) technology for International Normalised Ratio (INR) estimation and computerised decision support software (CDSS) have facilitated devolution of oral anticoagulation management to primary care. A study day with the specific aim of increasing primary care knowledge of anticoagulation management, and involvement in such practice, was set up in 1997 by the Department of Primary Care and General Practice at the University of Birmingham.
Acute arterial thrombosis in acute promyelocytic leukaemia
Emma Kalk and Peter Rose
pp 8-9
Ninety per cent of patients with acute promyelocytic leukaemia (APL) present with a severe haemorrhagic syndrome, out of proportion with the degree of thrombocytopaenia. Initially, this phenomenon was ascribed to disseminated intravascular coagulopathy (DIC) due to the release of tissue thromboplastins from blast cells. However, new data favour a fibrinolytic/protolytic process. The plasminogen receptor, annexin 11, is present in abnormally high amounts on the surfaces of leukaemic cells. This receptor is responsible for the linking of plasminogen to tissue plasminogen activator (tPA), activating plasmin and favouring fibrinolysis.
Outpatient treatment of DVT: time for a change?
Davina Gallagher and Abdul Shlebak
pp 10-11
St Mary’s NHS Trust in London has recently developed a protocol to facilitate the outpatient treatment of deep vein thrombosis (DVT). This service was set up not only to make long-term improvements to the quality of patient care, but also to relieve pressure on hospital beds. DVT occurs when a thrombus forms in the veins lying beneath the deep fibrous tissue, usually of the leg, thus obstructing the normal flow of blood. It affects approximately one person in every 1,000 in the UK. The typical presentation of the condition is a painful and/or swollen calf or thigh.

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)