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Volume 10, Number 1 |
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| The commissioning of anticoagulation management services in primary care |
Stephen Munday MB BCh FFPHM Director of Public Health, South Warwickshire Primary Care Trust |
Commissioners and primary care teams are increasingly becoming aware of the importance of anticoagulation management (ACM) services. There are a growing number of patients receiving anticoagulation therapy, particularly those who have non-rheumatic atrial fibrillation (NRAF) to reduce the risk of stroke and transient ischaemic attack. |
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| What makes a good consultation? |
Steve Johnson FRCP FRCPath Consultant Haematologist, Taunton and Somerset Hospital |
The clinical consultation is central to medical practice. It is the setting in which the doctor meets the patient and where clinical decisions are taken. The advice, investigation and treatment decisions that take place during the consultation have important implications for the patient and their family but also for the healthcare service and the wider economy of society. |
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| The role of D-dimer assays in predicting the risk of recurrence of VTE |
Farooq A Wandroo MBBS MD MRCP MRCPath Consultant Haematologist, Sandwell General Hospital, West Bromwich |
Patients who suffer from symptomatic venous thromboembolism (VTE) have a high risk of recurrent VTE that persists for many years. Knowledge of the risk of recurrence of a thrombotic event and its determinants is relevant for clinical policy regarding screening for thrombophilia, duration of anticoagulant treatment and prophylactic strategies. |
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| Low molecular weight heparin in pregnancy: is dose frequency relevant? |
Mark P Smith MBChB FRACP FRCPA Consultant Haematologist, Canterbury District Health Board, Christchurch, New Zealand |
Venous thromboembolism (VTE) is the most common cause of maternal mortality in the developed world and now accounts for more maternal deaths than eclampsia and puerperal sepsis combined. |
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| Lament for ximelagatran |
David Fitzmaurice, Editorial Board Member, and Peter Rose, Editor |
The search for a replacement drug for warfarin (and other coumarin derivatives) has been ongoing for some 50 years. There have been numerous variations of snake venoms and synthetic molecules, none of which have quite measured up in clinical trials. The past decade has seen increasing excitement about one particular molecule, melagatran (Exanta™, AstraZeneca, UK), which raised the prospect of a new oral anticoagulant preparation, given in a fixed daily dose and not requiring monitoring. |
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