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Volume 2, Number 4 |
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| Anticoagulant computer dosing – new challenges for the therapeutic management of patients |
Peter Rose, Editor |
It is now over ten years since the first computer applications for anticoagulant dosage were reported. However, some clinicians remain fearful of using computer-assisted dosage systems. This was discussed in a recent European multicentre trial, which, again, reported the benefits of computer-assisted dosage for the management of anticoagulant therapy.1 |
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| Managing drug interactions in the warfarin clinic |
Andrew Radley MPhil MRPharmS MCPP Director of Pharmacy, Perth and Kinross Healthcare NHS Trust |
Practitioners working in anticoagulant clinics soon come to appreciate that warfarin is affected by numerous factors. Interactions have been noted to occur with vaccines, non-prescription drugs and food items, as well as a huge range of prescribed medicines. Warfarin has been used in therapeutic practice for many years and its narrow therapeutic index and the limitations in methods used to determine its effect on blood clotting can mean that unexplained fluctuations in the international normalised ratio (INR) can often be attributed to the interference of a new prescription. |
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| Hyperhomocysteineaemia and vascular disease |
Anne Riddell MSc; Dale Owens PhD; David Perry MD PhD FRCP FRCPath Katharine Dormandy Haemophilia Centre and Haemostasis Unit, Department of Haematology, Royal Free Hospital, London |
In this, the concluding part of our series on homocysteine and vascular disease, we investigate the role of hyperhomocysteineaemia. |
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| Thrombophilia and foetal loss |
AJ Rai BSc MRCOG Lecturer; Lesley Regan MD FRCOG Professor, Department of Obstetrics and Gynaecology, Imperial College School of Medicine at St Mary’s, London |
The haemostatic system plays an important role in both the establishment and the maintenance of a pregnancy. The fibrinolytic pathways are intimately involved in ovulation and in the implantation of the fertilised egg into the uterine decidua. Once a pregnancy has been successfully established, an intact placental circulation is maintained by a balance between the coagulation and fibrinolytic systems. |
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| Access for GPs to Doppler ultrasound scanning |
Karl Johnson MRCP FRCR Consultant Radiologist, Birmingham Children’s Hospital; Thomas Goodfellow MRCP FRCR Consultant Radiologist, Walsgrave Hospital, Coventry; Richard Wellings MRCP FRCR Consultant Radiologist, Walsgrave Hospital, Coventry |
Patients presenting to their GP with calf pain is a common clinical problem but the diagnosis of a deep venous thrombosis (DVT) can be very difficult to make on clinical grounds alone.1,2 |
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