By Craig S. Kitchens MD, Craig M. Kessler MD, Shearer, Edith J. Applegate
This useful new source is helping readers deal with the entire diversity of clotting and bleeding problems quick and successfully. Written by way of a crew of revered clinicians, it examines indicators, laboratory findings, prognosis, differential analysis, and therapy. A reader-friendly layout and thousands of illustrations make it a vital instrument for busy physicians.The first strictly scientific source at the analysis and remedy of clotting and bleeding issues. includes a bankruptcy at the consultative method in addition to insurance of the interface of hematology with cardiology, oncology, bloodbanking, pharmacology, and extensive care medication. offers a whole part on women's concerns, which include analyses of OCPs/estrogen remedy, bleeding with being pregnant, and antiphospholipid syndrome and being pregnant. Examines the impression of HIV, outpatient anticoagulation, continual venous insufficiency, inferior vena cava filters, and different matters in a bit on specific issues. Clarifies laboratory protocols, assisting readers decide on and interpret lab checks extra simply. offers the fundamental technological know-how physicians have to perform successfully.
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Additional info for Consultative Hemostasis and Thrombosis
Have you ever experienced spontaneous bleeding, poor wound healing, or dehiscence of a surgical wound? A spontaneous hemorrhage is one that occurs in the absence of any identifiable trauma other than the stress of weight bearing. , epistaxis, melena, menorrhagia) is more commonly associated with severe thrombocytopenia (defined as a platelet count <10,000/mL), qualitative platelet dysfunction, or V WD. Spontaneous cutaneous bruising in the form of purpura is often a feature of prolonged corticosteroid administration, Ehlers-Danlos syndrome, or the senile purpura syndrome.
Whole blood impedance lumiaggregometry, which measures chemiluminescence-based platelet activation, aggregation, and adenosine triphosphate (ATP) release from dense granules, remains to be validated in its ability to predict clinical bleeding or thrombotic propensity (see Chapter 10). Similarly, methods used to assess the vague clinical condition referred to as “aspirin resistance” remain to be correlated with the occurrence of myocardial infarction, stroke, or death from vascular events. S. Food and Drug Administration to specifically detect aspirin resistance; these are based on assessment of platelet cyclo-oxygenase enzyme pathway activity.
11 Unfortunately, each woman’s definition of menorrhagia can be somewhat vague, rendering menorrhagia a relatively poor indicator of an underlying coagulation disorder. 12 Numerous bleeding scales have been devised to circumvent this variability, but these may be very cumbersome to use. , longer than 7 days total), and the number of pads or tampons used. The accuracy of this latter factor, however, may vary as it depends on the individual patient’s hygienic habits and fastidiousness. The recent addition of menstrual symptometric devices, such as pictorial blood assessment charts,13,14 has improved the accuracy of quantifying excessive blood loss, which would be useful in diagnosing underlying coagulopathy.