Thrombus - 2005

Thrombo-haemorrhagic complications in primary (essential) thrombocythaemia
David Bareford
pp 1-4
Primary thrombocythaemia (PT) is a chronic myeloproliferative disorder, characterised by a sustained proliferation of megakaryocytes, which lead to increased numbers of circulating platelets. Due to a lack of specific diagnostic markers, diagnostic criteria for primary thrombocythaemia have been established that are directed primarily at the exclusion of other myeloproliferative disorders and reactive thrombocytosis (see Table 1). However, those fitting the criteria of PT still represent a heterogeneous disorder with a proportion showing no evidence of a clonal disorder.
Comment: VTE – a greater danger than MRSA
Peter Rose
pp 2-2
The old adage that prevention is better than cure is a current focus in our hospitals to reduce the wellpublicised increasing problems of methicillinresistant Staphylococcus aureus (MRSA) infection. Unfortunately, this adage does not appear to be the case when it comes to prevention of venous thromboembolic disease (VTE). At a recent Commons Health Committee Meeting on the prevention of VTE in hospital patients, it was suggested that four to six times more hospital deaths may be attributed to VTE than MRSA infection. While the general public appear well informed of the current risks of MRSA in association with hospital admission, many patients and some doctors do not recognise VTE as a major cause of morbidity and mortality in our elderly hospital population.
Heparin-induced skin necrosis as a manifestation of thrombocytopenia
Adam Ashley and Richard Murrin
pp 5-6
Heparin-induced thrombocytopenia (HIT) is gaining increased recognition as a complication of perioperative prophylaxis against venous thromboembolism (VTE). Heparininduced thrombocytopenia type II, in contrast to type I, can be associated with paradoxical thrombosis, most commonly as arterial occlusion. The case of one patient, who developed skin necrosis as a result of proven HIT type II, is presented here. These lesions arose as two discrete areas over the anterior abdominal wall, corresponding to injection sites of subcutaneously administered low molecular weight heparin (LMWH).
Thromboembolic disease: paradoxical increased risk of thrombosis after initiation of oral anticoagulation
Habib Rehman
pp 7-9
Oral anticoagulants are being increasingly used in clinical practice and are effective in the primary and secondary prevention of venous thromboembolism, in the prevention of systemic embolism in patients with prosthetic heart valves or atrial fibrillation, and in the prevention of stroke, recurrent infarction and death in patients with acute myocardial infarction. The therapeutic approach for patients with thromboembolic disease typically starts with low molecular weight heparin (LMWH), followed by oral anticoagulation.
Annual review anticoagulation clinics
Barry O’Donoghue and David Fitzmaurice
pp 10-11
The number of patients taking oral anticoagulation (predominantly warfarin in the UK) has increased considerably over the past few years. This is largely related to the increasing numbers of patients with nonrheumatic atrial fibrillation being treated with warfarin. This article discusses the potential benefits of an annual review anticoagulation clinic (ARAC) to facilitate optimum care for patients on warfarin therapy.

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)