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Volume 9, Number 3 |
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| What does the future hold for anticoagulant nurses? |
Caroline Baglin RGN Thrombophilia Nurse Specialist, Addenbrooke’s Hospital, Cambridge |
All professionals should examine their role on a regular basis. However, the future of anticoagulant nurses has been highlighted by several recent developments. Many of these nurses fear redundancy. Instead of being defensive about their role, they should use this debate as a time to reflect on their work and develop strategies for the future. |
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| Aortic tissue valves: aspirin or warfarin? |
Peter Rose, Editor |
Following the first mechanical heart valve replacements more than 40 years ago, unacceptably high rates of arterial thromboembolic complications were soon reported. This led to the routine use of anticoagulant prophylaxis with inhibitors of vitamin K-dependent clotting for long-term prophylaxis in patients receiving mechanical heart valves. |
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| Pathology, presentation and treatment of Behçet’s disease |
Tony Todd MB ChB MRCP Specialist Registrar in Haematology; Katherine Lowndes MB ChB MRCP Specialist Registrar in Haematology, Department of Haematology, Addenbrooke’s Hospital, Cambridge |
Behçet’s disease is named after the Turkish dermatologist who described it in three patients with oral and genital ulceration and hypopyon uveitis in 1937.1 Three years later, he reported four similar cases and named the combination of symptoms the ‘triple symptom complex’.2 |
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| Post-thrombotic syndrome |
Robert Weinkove MA MRCP Specialist Registrar in Haematology, Department of Haematology, Darent Valley Hospital, Dartford; Savita Rangarajan MRCP MRCPath Consultant Haematologist, The Centre for Haemostasis and Thrombosis, St Thomas’ Hospital, London |
Post-thrombotic syndrome (PTS) is a common, debilitating and potentially preventable long-term complication of deep vein thrombosis (DVT). It is characterised by chronic pain, oedema, skin changes and ulceration of the affected limb. PTS occurs in 30% of patients following DVT, and is severe in 10%. The incidence of PTS can be reduced by ensuring an adequate duration and intensity of anticoagulation following DVT and pulmonary embolism (PE), preventing future thrombosis with appropriate thromboprophylaxis, and by daily use of elastic compression stockings. |
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| Clinicians’ use of the VQ scan for diagnosis of pulmonary embolism |
Paul Beckett MB BChir MRCP Consultant Respiratory Physician; Sutapa Biswas MB BS Senior House Officer, Queen’s Hospital, Burton-on-Trent |
Pulmonary embolism (PE) is a common problem that is often misdiagnosed. The true incidence is thought to be approximately 1% of all hospital admissions.1,2 PE is not suspected clinically in up to 70% of patients in whom it is subsequently found to be a major cause of death.1 Similarly, autopsy studies show no evidence of PE in up to 60% of patients recently diagnosed with it.3 |
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