Thrombus - 2005

Polycythaemia vera and portal vein thrombosis
David Jackson
pp 1-3
Polycythaemia vera (PV) is a myeloproliferative disorder characterised by marrow proliferation, together with an elevated red cell mass. It occurs in approximately two to 13 cases per million population, with significant geographic variation. The mean age at diagnosis is 60 years. It is distinguished from the other myeloproliferative disorders (for example, thrombocythaemia) through analysis of peripheral blood and bone marrow, together with genetic markers to specifically exclude chronic myeloid leukaemia. There is as yet no identified diagnostic genetic marker for PV and so the diagnosis is based on a combination of laboratory tests, that exclude secondary causes and are indicative of the disorder, together with clinical features. Diagnostic criteria have therefore been proposed by a number of groups.
Comment: Interaction between cranberry juice and warfarin – fact or fiction?
Peter Rose
pp 2-2
The Medicines and Healthcare products Regulatory Agency (MHRA) has recently reminded us of a possible interaction between warfarin and cranberry juice.1 Its advice is that patients taking warfarin should avoid cranberry juice, or other cranberry products unless health benefits are considered to outweigh any risks. Cranberry (Vaccinium macrocarpon) juice is an effective agent commonly used to reduce bacteria in the urinary tract and reduce the frequency of recurrent cystitis. Kontiokari et al2 showed that 50 ml of cranberry–lingonberry juice concentrate daily for six months reduced the frequency of recurrent urinary tract infection by 50% in the cranberry group, whereas a Lactobacillus drink was ineffective.
Tinzaparin for thromboprophylaxis and treatment during pregnancy
Mark P Smith
pp 4-6
Low molecular weight heparins (LMWHs) have become the primary therapeutic choice for management and prevention of venous thromboembolism (VTE) during pregnancy. LMWHs do not bind to the endothelium and have a low affinity for plasma proteins, resulting in consistent bioavailability and elimination kinetics. LMWH may therefore have substantial advantages over unfractionated heparin for use during pregnancy. Principal thrombophilic states include: deficiency of antithrombin; protein C or protein S; the G1691A substitution associated with factor V Leiden; the prothrombin G20210A substitution; prosthetic heart valves; native valvular heart disease; and the antiphospholipid syndrome (APS). Women in pregnancy may present with a history of thrombosis, with or without these defined thrombotic conditions.
Focus on ICT meeting – Slovenia 2004
Sarah Bond and Michelle Taylor
pp 7-9
The recent 18th International Congress on Thrombosis took place in June 2004 in Ljubljana, Slovenia. It was well attended and of great interest, with presentations and symposia on a range of varied topics. Again, as with other recent meetings, there was a focus on the impending new direct thrombin inhibitors (DTIs) but there were also several interesting symposia on the diagnosis, management and issues surrounding venous thromboembolism (VTE) and oral anticoagulation.
TEG testing during surgery
Barry Hill
pp 10-11
Increasing elective surgery within the UK over the last decade has created a surge in demand for the use of donated blood and other components, such as platelets and fresh frozen plasma (FFP). Despite the fact that the National Blood Service (NBS) collects and processes approximately 3 million donations each year, the demand for blood continues to rise. Studies in the United States and France have shown that more than half of transfused red cells go to surgical patients. However, there is new evidence emerging that medical indications, primarily due to anaemia, are also becoming increasingly responsible for more and more transfusions. Thromboelastography (TEG) testing is a technique that has been introduced to reduce the use of the blood supply.

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