Volume 5, Number 1

Peter Rose, Editor

In approximately 20% of new cases of deep vein thrombosis (DVT) there is a history of underlying malignancy. In these cases the management of the malignancy is complicated by the need for anticoagulation, while the prethrombotic state resulting from the malignancy can alter anticoagulant requirements. Little is known about the optimal management of this group of patients. Current research is focused on identifying increasingly rare heritable causes of thrombophilia to satisfy the interest of haematologists and geneticists alike, with little input into this common cause of DVT.

Kath Yates PA to Dr O’Shaughnessy – Consultant Haematologist, Southampton General Hospital

At Southampton University Hospitals Trust (SUHT) there has been the continuing problem of growing numbers of referrals from GPs and consultants for thrombophilia screening.

Sarah L Allford MA MRCP Haematology Research Fellow, University College Hospital, London

Unstable angina, non-Q-wave myocardial infarction (MI) (or non-ST segment elevation MI) and Q-wave MI are all acute manifestations of ischaemic heart disease. Atheromatous plaque rupture is often the underlying pathological precipitant with consequent platelet activation, thrombus formation and vessel occlusion. Platelets are a significant component of this thrombus1 and may remain activated for at least one month post-presentation.2 Primary therapy is directed at reopening the vessel and re-establishing perfusion, which must subsequently be maintained. Antiplatelet agents are increasingly used in all of these areas.

Sandra Young Min BSc(Hons) MRCP MRCPath Specialist Registrar in Haematology, Birmingham Children’s Hospital, Birmingham

Increasing numbers of the population are taking long-term anticoagulation and this looks likely to continue.1 Although haemorrhage remains the main side-effect of anticoagulation, the occurrence of osteopenia and osteoporosis may be related to anticoagulation.

Paul L Cervi MRCPI FRCPath Consultant Haematologist; Robert Duck, IT Manager, Basildon & Thurrock NHS Trust, Nether Mayne, Basildon, Essex

At Basildon and Thurrock we have delivered more than 13,000 INR results by phone to our active client population (nine months after introduction; 1,755 evaluable patients, 51% over 70 years age). There are 1,419 (81%) patients using the system regularly, with 336 (19%) non-users.