Thrombus - 2010

What will be the role of warfarin in atrial fibrillation in the future?
David A Fitzmaurice
pp 1-4
The Framingham Heart Study has identified atrial fibrillation (AF) as an independent risk factor for cerebrovascular accidents, even in the absence of mitral valve disease. The relative risk for stroke associated with AF must be of primary consideration, given that oral anticoagulation carries its own risks. The Whitehall study and the British Heart study also found that an increased risk of stroke was associated with AF; however, the relative risks differed somewhat, as did the underlying rate of stroke within the control population.

Comment: EHEC and haemolytic uraemic syndrome
Peter Rose
pp 2-2
Infection with enterohaemorrhagic Escherichia coli (EHEC) remains the most common cause of haemolytic uraemic syndrome (HUS) in the UK. HUS is characterised by a microangiopathic haemolytic anaemia, thrombocytopenia and renal failure. It represents the most common cause of acute renal failure in childhood and continues to make national headlines as new outbreaks occur. The most prevalent form in the UK is that induced by Shiga toxinproducing Escherichia coli (E coli) serotype 0157:H7. The longer-term clinical consequences remain severe for some patients. Death or endstage renal disease occurs in up to 12% of patients with HUS, with 25% of survivors demonstrating long-term renal sequelae.

Coagulation parameters: overview and changes in patients with pre-eclampsia
Chris Gardiner
pp 5-7
Pre-eclampsia is a relatively common disorder, affecting about 5% of pregnancies, and is characterised by hypertension, proteinuria and inflammation. Pre-eclampsia may be thought of as an excessive maternal inflammatory response to pregnancy, the root cause of which is considered to be placental oxidative stress secondary to abnormal placentation. During normal pregnancy, the placenta syncytiotrophoblast releases syncytiotrophoblast microparticles (STBMs) and soluble inflammatory mediators into the maternal circulation, leading to a low-level physiological inflammatory response.

Pulmonary hypertension secondary to venous thromboembolism
Padmaja Lokireddy, Peter Rose and Anton Borg
pp 8-10
Pulmonary hypertension (PH) is a chronic, progressive disease that causes increased pulmonary vascular resistance that ultimately leads to right-heart failure and premature death. Chronic thromboembolic pulmonary hypertension (CTEPH) is thought to result from single or recurrent thromboemboli arising from sites of venous thrombosis. CTEPH is associated with considerable morbidity and mortality and forms group 4 of the Evian/World Health Organization (WHO) classification system for PH.

Mechanical thromboprophylaxis
Lynda Bonner
pp 11-14
A variety of mechanical thromboprophylactic treatment modalities are available to reduce the risk of venous thromboembolism (VTE), including anti-embolism stockings (AESs), intermittent pneumatic compression (IPC), footpumps, electrical stimulation devices and mobilisation/exercise. Using these appropriately, safely and effectively involves a process of selection, implementation and education.

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)