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Volume 8, Number 1 |
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| New anticoagulants: major advances and patient needs |
Patrick Kesteven MBBS FRCP PhD Consultant Haematologist; Brian Robinson BSc(Hons) FIBMS RGN Anticoagulant Nurse, Freeman Hospital, Newcastle-upon-Tyne |
Both unfractionated heparin (UFH) and warfarin have been in clinical use for over 50 years. Both are well, but not fully, understood, inexpensive and effective, with a reasonable safety profile. In most clinical situations, both require careful laboratory monitoring and dose adjustment. |
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| Informing patients about their drug sources – how far should you go? |
Hayley Flavell RGN DPSN BSc Anticoagulant Clinical Nurse Specialist, Russells Hall Hospital, Dudley |
Low molecular weight heparin (LMWH) is a form of anticoagulant that is derived from the intestines of pigs;
it is a byproduct of the sausage industry.1 LMWHs are widely used in the prophylaxis and treatment of deep vein thrombosis (DVT) and pulmonary embolism. |
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| Guidelines for patient self-testing and self-management of oral anticoagulation |
Deborah McCahon BSc MSc Research Associate; Ellen Murray RGN MSc Research Fellow and Practice Nurse; David Fitzmaurice MBChB MRCGP MD Professor in Primary Care Research and GP, Department of Primary Care and General Practice, The Medical School, The University of Birmingham, Edgbaston |
Patient self-management (PSM) of warfarin therapy is comparable to home glucose monitoring using a portable glucometer,1 and may provide a robust model of service provision, with improvements in patients’ self-efficacy, closer treatment adherence and increased control of oral anticoagulant therapy.2 |
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| Thrombosis in children Part 1: incidence, risk factors and diagnosis |
Elene Psiachou-Leonard MRCP (I) MRCPCH Consultant Paediatric Haematologist, University Hospitals of Leicester NHS Trust; Denise O’Shaughnessy FRCP FRCPath DPhil MBA Consultant Haematologist, Senior Medical Officer, Blood Policy Unit, Department of Health, London |
Thromboembolism (TE), venous or arterial, is rare in childhood and when present is associated with underlying acquired or hereditary disorders.1,2 Thromboembolism in children is an increasingly recognised entity – particularly within certain paediatric subspecialties such as neonatology, intensive care, cardiology, cardiac surgery and oncology. |
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| The real cost of warfarin for patients with atrial fibrillation |
Peter Rose, Editor |
In this issue, we read of the exciting development of new anticoagulant treatments. Ximelagatran, a reversible direct thrombin inhibitor, is set to be the first new oral anticoagulant since the introduction of warfarin nearly 60 years ago. |
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