Current guidelines on lupus anticoagulant screening Ian Jennings pp 1-4 Guidelines on lupus anticoagulant (LA)
screening or testing have been regularly
published for over 25 years. Thrombus 14.2
reviewed the history of LA guidelines, and
this article summarises the recommendations
in the latest guidelines, which were
published in the Journal of Thrombosis and
Haemostasis in October 2009.
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Comment: More on superficial vein thrombosis Peter Rose pp 2-2 In recent issues we have published
reviews about the management of
superficial thrombophlebitis and the value of
anticoagulant therapy. The dilemma is
illustrated by the fact that the same data can
be argued to show both benefit and lack of
efficacy for anticoagulant therapy.
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Monitoring new anticoagulants Patrick Kesteven and Steve Kitchen pp 5-6 When testing for an anticoagulant
effect, a distinction needs to be made
between measuring and monitoring.
Measuring an anticoagulant is when
we attempt to determine if any
anticoagulant is present in the patient’s
plasma. This is an essential requisite
in haemorrhagic emergencies, when
determining if invasive procedures are
safe, or when there is concern that the
drug may be accumulating in cases
with deteriorating renal function.
Monitoring, however, refers to the
act of determining if blood levels are
therapeutic, a much more difficult and,
to some, contentious endeavour.
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Comparison of Canadian and UK anticoagulation and thrombosis services Davina Gallagher pp 7-10 Davina Gallagher has spent the last ten
years working as a Clinical Nurse
Specialist (CNS) in Anticoagulation and
Thrombosis managing nurse-led services
in primary and secondary care, and
acting as a consultant for GPs regarding
anticoagulation and service delivery. She
has also worked as a trainer and
educator for practice nurses, rising to the
challenge of running nurse-led
anticoagulant clinics in primary care, as
well as the usual clinical and managerial
aspects of the role of the CNS. Below is
Davina’s personal account of her
experience working in Canada, and a
comparison of how their thrombosis
services compare with the UK.
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The NVTH/BSHT joint symposium 2010 Caroline Baglin pp 10-10 The Nederlandse Vereniging voor
Trombose en Hemostase (NVTH) and
the British Society for Haemostasis
and Thrombosis (BSHT) held a joint
meeting in Noordwijkerhout in the
Netherlands in June 2010.
The meeting was opened by Fritz
Rosendal, Chairman of the NVTH and
Trevor Baglin, President of the BSHT.
The aim of the meeting was to
strengthen links between the two
societies and to give their staff the
opportunity to present their research
and clinical findings.
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A guide to bridging anticoagulation Mohamed M Khan and Henry G Watson pp 11-12 The management of perioperative
anticoagulation in patients on vitamin K
antagonists (VKAs) is a problem
frequently encountered in clinical
practice. When considering perioperative
anticoagulation strategies in patients
receiving oral anticoagulants, clinicians
need to weigh up the risk of bridging
therapy-associated bleeding against the
risk of thrombosis associated with the
temporary discontinuation of treatment.
To allow appropriate clinical decisionmaking,
both patient-specific and
procedure-specific risk need to be
considered.
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Management of superficial venous thrombophlebitis: the case for LMWH Anne Kelly pp 14-15 Superficial venous thrombophlebitis
(SVT) is a common condition that
generally presents in the primary care
setting. Incidence is said to be higher
than that of venous thrombosis, which is
quoted as approximately one per 1,000.
A typical patient presents with pain over
the site of a prominent superficial vein
and associated erythema. The commonest
site for SVT is the lower limb (usually the
long saphenous vein); however, it can
also occur in the upper limb and neck.
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