|
|
Pain & Pain Management
|
|
A systematic review of prolotherapy for chronic
musculoskeletal pain. |
|
|
Clin J Sport Med. 2005
Sep;15(5):376-80. CONCLUSIONS: There are limited
high-quality data supporting the use of
prolotherapy in the treatment of musculoskeletal
pain or sport-related soft tissue injuries.
Positive results compared with controls have
been reported in nonrandomized and randomized
controlled trials. Further investigation with
high-quality randomized controlled trials with
noninjection control arms in studies specific to
sport-related and musculoskeletal conditions is
necessary to determine the efficacy of
prolotherapy. |
| |
|
Antidepressants for the Treatment of Neuropathic
Pain |
|
|
|
| |
|
Comorbid Depression, Chronic Pain, and
Disability in Primary Care |
|
|
Psychosomatic Medicine
68:262-268 (2006) © 2006 American Psychosomatic
Society. Conclusions: Chronic pain is common
among those with MDD. Comorbid MDD and disabling
chronic pain are associated with greater
clinical burden than MDD alone. |
| |
|
Consequences of Persistent Pain |
|
|
US Pharm. 2008;33(5):28-30.
Conclusion: Clinical manifestations of
persistent pain are usually multifactorial.
Pharmacists should develop an understanding of
the nature of persistent pain with regard to its
consequences and ultimate potential to cause
physical impairment, psychologic disability, and
social withdrawal. By integrating this knowledge
with appropriate pharmaceutical recommendations
and ongoing pain assessment, individualized
medication regimens for persistent pain may be
achieved. |
| |
|
For Grace |
|
|
For Grace is a nonprofit
organization passionately devoted to raising
awareness of Reflex Sympathetic Dystrophy and
the plight of women in pain. |
| |
|
Healing Touch International |
|
|
Healing Touch is a holistic
energy therapy that emphasizes compassionate,
heart-centered care in which the Healing Touch
provider and client are equal partners in
facilitating health and healing. Healing Touch
providers use gentle, non-invasive touch to
influence and support the human energy system
within and surrounding the body. The goal of
Healing Touch is to restore harmony, energy and
balance within the human energy system. This
goal supports the client's self-healing process
of becoming whole in body, mind, emotion and
spirit. The Merriam-Webster dictionary lists the
primary definition of "Healing" as "to make or
become healthy, sound, or whole". Healing Touch
complements conventional health care and is also
used in collaboration with other approaches to
health and healing. |
| |
|
Holistic assessment of pain and chronic wounds |
|
|
Maureen Benbow discusses the
need for holistic assessment of pain in patients
with chronic wounds. Maureen Benbow MSc, BA,
HERC, RGN is a Senior Lecturer, University of
Chester. Article accepted for publication:
December 2005 |
| |
|
Improving State Pain Policies |
|
|
CA Cancer J Clin 2007;
57:341-353. |
| |
|
Management of Chronic Low Back Pain |
|
|
US Pharm. 2008;33(5):34-43.
Summary: Pharmacists can continue to play a
critical role in the management of CLBP due to
their accessibility and frequent contact with
patients in the community. With proper
education, patients with CLBP can manage their
pain more effectively in an effort to decrease
the significant societal burden resulting in
costly medical bills and lost productivity.
Increased awareness of current guidelines for
pharmacologic as well as nonpharmacologic
therapy will help to provide effective
management of CLBP. In addition, the
implementation of pharmacist-directed pain
clinics may provide more effective patient care
through regular monitoring and titration of
analgesics in an effort to help patients meet
reasonable pain-specific goals. Future
considerations for the management of CLBP
include the evaluation of combination
pharmacologic agents as well as additional
research to assess decision tools or methods for
tailoring therapy. |
| |
|
Management of Common Opioid-Induced Adverse
Effects |
|
|
Am Fam Physician
2006;74:1347-54. Copyright © 2006 American
Academy of Family Physicians. Opioid analgesics
are useful agents for treating pain of various
etiologies; however, adverse effects are
potential limitations to their use. Strategies
to minimize adverse effects of opioids include
dose reduction, symptomatic management, opioid
rotation, and changing the route of
administration. Nausea occurs in approximately
25 percent of patients; prophylactic measures
may not be required. Patients who do develop
nausea will require antiemetic treatment with an
antipsychotic, prokinetic agent, or serotonin
antagonist. Understanding the mechanism for
opioid-induced nausea will aid in the selection
of appropriate agents. Constipation is
considered an expected side effect with chronic
opioid use. Physicians should minimize the
development of constipation using prophylactic
measures. Monotherapy with stool softeners often
is not effective; a stool softener combined with
a stimulant laxative is preferred. Sedation and
cognitive changes occur with initiation of
therapy or dose escalation. Underlying disease
states or other centrally acting medications
often will compound the opioid's adverse
effects. Minimizing unnecessary medications and
judicious use of stimulants and antipsychotics
are used to manage the central nervous system
side effects. Pruritus may develop, but it is
generally not considered an allergic reaction.
Antihistamines are the preferred management
option should pharmacotherapy treatment be
required. |
| |
|
Management of Pain in Acute Illness |
|
|
US Pharm.
2008;33(5):HS-4-HS-9. Conclusion: The selection
of analgesics in the acute-care setting requires
a careful consideration of the coexisting
disease states and the potential for interaction
between drug and disease. Care should be taken
to ensure that the changes occurring during an
acute illness do not compromise the safety of
the selected analgesic and that the selected
analgesic does not promote the severity of the
illness. |
| |
|
Measuring troublesomeness of chronic pain by
location |
|
|
BMC Musculoskeletal Disorders
2006, 7:34 doi:10.1186/1471-2474-7-34.
Conclusions: The troublesomeness grid is well
completed and appears to be an appropriate tool
to assess the comparative severity of pain in
different body regions. |
| |
|
Methadone Treatment for Pain States |
|
|
Methadone is a synthetic
opioid with potent analgesic effects. Although
it is associated commonly with the treatment of
opioid addiction, it may be prescribed by
licensed family physicians for analgesia.
Methadone's unique pharmacokinetics and
pharmacodynamics make it a valuable option in
the management of cancer pain and other chronic
pain, including neuropathic pain states. It may
be an appropriate replacement for opioids when
side effects have limited further dosage
escalation. Metabolism of and response to
methadone varies with each patient. Transition
to methadone and dosage titration should be
completed slowly and with frequent monitoring.
Conversion should be based on the current daily
oral morphine equivalent dosage. After starting
methadone therapy or increasing the dosage,
systemic toxicity may not become apparent for
several days. Some medications alter the
absorption or metabolism of methadone, and their
concurrent use may require dosing adjustments.
Methadone is less expensive than other
sustained-release opioid formulations. Am Fam
Physician 2005;71:1353-8. Copyright© 2005
American Academy of Family Physicians |
| |
|
New Research Findings in Chronic Pain: An Expert
Interview With Frederick W. Burgess, MD, PhD |
|
|
The American Academy of Pain
Medicine 23rd Annual Meeting took place from
February 7 to 10, 2007 in New Orleans,
Louisiana. During this meeting, new information
about the diagnosis and treatment of pain
disorders was presented. Marni Kelman, MSc,
Medscape Neurology & Neurosurgery Editorial
Director, discussed results presented at this
year's meeting and their implications with
Frederick W. Burgess, MD, PhD, Clinical
Associate Professor of Surgery (Anesthesiology),
Brown University, The Warren Alpert Medical
School, Providence, Rhode Island; Attending
Anesthesiologist, Rhode Island Hospital,
Providence, Rhode Island. |
| |
|
Pain Control: What Works Best? |
|
|
US Pharm. 2006;5:8. |
| |
|
Pain is unpleasant, but a vital clue to what's
wrong |
|
|
February 17, 2007. PAIN is a
great motivator. Unsurprisingly, it's one of the
main reasons people present to a doctor, and a
powerful reminder to continue therapy. If
elevated blood pressure, sugar or cholesterol
caused pain, far fewer people would neglect to
take their controlling medication. |
| |
|
Pain Management Health Center |
|
|
Chronic pain affects an
estimated 86 million American adults to some
degree. Here you'll find the latest information
on chronic pain treatments, as well as natural
ways to manage your chronic pain. Plus, get help
daily in our online support group. |
| |
|
Prevalence of Americans Suffering from Pain |
|
|
US Pharm. 2006;5:11. |
| |
|
Reflex Sympathetic Dystrophy (RSD) Syndrome
Association |
|
|
The Reflex Sympathetic
Dystrophy Syndrome Association was founded in
1984 to promote public and professional
awareness of Reflex Sympathetic Dystrophy
Syndrome (RSD or RSDS), also known as Complex
Regional Pain Syndrome (CRPS I). |
| |
|
The Healing Power of Hypnosis |
|
|
The latest research shows
that it eases pain, speeds healing, increases
fertility, even fights cancer. |
| |
|
The Healing Touch |
|
|
|
| |
|
Which analgesic is right for my patient? |
|
|
Nursing2006, July 2006,
Volume 36 Number 7, Pages 50 - 55. |
| |
|
Top of Page |
|
|
Personal Medical Stories
|
|
"Friends Star Expecting First Baby" |
|
|
7 JANUARY 2004 Friends star
Courteney Cox has announced she is looking
forward to the birth of her first child. "We are
confirming they are expecting," said her
publicist, Nanci Ryder, who declined to give any
further details. The happy news is especially
significant for Courtney and her actor husband
David Arquette, as they have experienced
long-running fertility problems. The couple, who
married in 1999, revealed last year that they
were attempting to conceive via in-vitro
fertilisation after suffering what they
described as "many miscarriages". "I actually
have done IVF. It's a wonderful thing that
people can do in this day and age," said the
actress. "And I'm lucky enough to be able to
afford to do it. I think it's great and I will
do it again." Courteney's pregnancy coincides
with the last season of her sitcom Friends. In
the final series her onscreen character, Monica,
has been exploring adoption after being unable
to conceive. When the shows are broadcast this
spring, one of the most popular comedies in US
television history will come to an end. |
| |
|
*Tina's New APS Articles and Information Page |
|
|
This page is to replace her
Blog page. |
| |
|
A Husband Recalls His Wife's Year Living with
APS |
|
|
written by Mike Stuart |
| |
|
A Story of Strength |
|
|
written by Elaine McGonagle |
| |
|
A Successful APS Story ~ My 4 Miracles |
|
|
written by Michele Balara |
| |
|
All I get is to lose my mind! |
|
|
|
| |
|
An APS Survivor ~ Larinda's Story |
|
|
written by Larinda Brown |
| |
|
An Interview With Someone Who Has Experienced
Three Subdural Hematomas |
|
|
Last updated August 29, 2004 |
| |
|
APS Patient and Chorea |
|
|
This is a link to videos of a
young girl with APS who also has chorea due to
the APS. |
| |
|
APS Patient Video |
|
|
Another APS Patient Video |
| |
|
APS Took My Breath Away |
|
|
Written by: Franny Bishop |
| |
|
APS ~ Just A Part of Us (Todd’s Story) |
|
|
Written by: Heidi Ponagai,
wife of Todd Ponagai |
| |
|
Call for tests to avoid misdiagnosis of MS |
|
|
Filed: 07/31/2006. |
| |
|
Christine's Story |
|
|
|
| |
|
Collison with Hidden Risk Factors |
|
|
by Anne Sigmon, Survivor -
Lafayette, CA. Published in Stroke Connection,
Nov/Dec 2004, pages 22-25 |
| |
|
Diseases Doctors Often Miss |
|
|
Diseases Doctors Often Miss
by Gurney Williams III, Family Circle, January
18, 2005, Pages 64-71 |
| |
|
Do You Know Who I Am? |
|
|
Written by: Richelle |
| |
|
Duke Consortium Saves Sufferers of Deadly
Clotting Disorders |
|
|
An APS patient nearly died of
his rare blood disoder until Duke doctors
diagnosed and successfully treated him. |
| |
|
Elena’s APS Story |
|
|
Written by: Elena Gonzalez |
| |
|
Father/Daughter APS Patient Story |
|
|
Written by: Sylvia from
Arcadia, FL USA. I'm 16 years old, and I have an
autoimmune disease called Antiphospholipid
Antibody Syndrome (APS). I was diagnosed with it
after my dad suffered his first DVT. They tested
him for it because there wasn't a reason why an
active young man such as my father should
develop a blood clot. After his problems started
getting worse, we decided that my brother and I
should get tested as well. The doctor didn't
want to test us as he said the chance of us
having it was very low. My brother came back
negative but I tested positive. |
| |
|
Friends actress Cox has baby girl |
|
|
Courtney Cox Arquette - best
known for playing Friends character Monica
Geller - has had a baby girl. The baby was
delivered on Sunday morning and named Coco
Arquette. The actress, who turned 40 on Tuesday,
has struggled both on screen and in real life to
have a baby, suffering a number of miscarriages
in the past. Cox and film actor David Arquette,
who married in 1999, have spoken about their
battle for a baby and said they would try IVF in
an effort to conceive. Cox is currently
preparing for life without Friends with the
sitcom ending after 10 seasons. This year's
episodes followed her character Monica's
attempts to adopt a child. |
| |
|
Having a New Disease |
|
|
|
| |
|
Holly's Story of Hope |
|
|
Holly's personal page
describing her APS diagnosis and loss of her
daughter, Hope. |
| |
|
How men cope with miscarriage |
|
|
John Itsagwede explains how
he and his wife dealt with the pain of losing
three babies |
| |
|
Hundreds wrongly told they are MS sufferers |
|
|
FOR more than two decades,
John Simper was resigned to a slow and painful
death from multiple sclerosis. |
| |
|
I am Thankful ~ Bob’s Story |
|
|
Written by: Bob Clift |
| |
|
I was told I had MS - but the doctors were wrong |
|
|
Jeremiah Johnston-Sheehan, a
successful architect, was devastated when told
he had multiple sclerosis. But four years later,
he discovered that he had been misdiagnosed. |
| |
|
Living with Hughes Syndrome for past five years |
|
|
by Zandy Dudiak. Woodland
Area Progress Star. June, 4, 2003. Page 32.
Featuring Maria Villiotti. |
| |
|
Lucky to be alive, 'The Monster' ready to study
nursing |
|
|
Stonewall Jackson senior
Brittany Nunemaker, 18, of New Market, displays
her excitement on the rear window of her car on
her upcoming graduation. She suffers from a
disease which causes excessive blood clotting.
She overcame a near-death experience with the
disease and was inspired to become a nursing
student this fall at Massanutten Technical
Center. |
| |
|
Mark Hackley: A Country Singer’s Life-Changing
Story |
|
|
Written by: Joanne DiMaggio
For years, country singer/song writer Mark
Hackley performed his songs without a glitch.
That all changed in June 2006. What began
innocently enough as a routine performance of a
private concert in northern Virginia soon turned
into a life-threatening event that would change
Mark’s life forever. |
| |
|
My Journey with APS ~ Kristina’s Story |
|
|
Written by: Kristina Waggoner |
| |
|
My Life with APS ~ Nan's Story |
|
|
written by Nan Smith |
| |
|
New Hope For MS Sufferers |
|
|
Hazel Edwards was diagnosed
with MS five years ago. She deteriorated rapidly
and was paralyzed from the neck down. But after
being correctly diagnosed by Professor Hughes as
having sticky blood, she started treatment with
warfarin. She is now so fit she goes to the gym
four times a week. |
| |
|
Saved by a Little Pill |
|
|
|
| |
|
Sheriff's deputy donating kidney to close friend |
|
|
|
| |
|
Stella Never Had A Chance |
|
|
|
| |
|
Sticky Blood: Tragedy and Hope |
|
|
|
| |
|
The Gift of the Blue Balloon ~ Daniela’s Story |
|
|
written by: Daniela Kowal |
| |
|
The Winding Path ~ Dana's Story |
|
|
written by Dana Stuart |
| |
|
What Your Spouse Doesn’t Know Can Kill Them:
Discovering My Wife Has APS |
|
|
Written by: Tony Gilbert |
| |
|
Top of Page |
|
|
Pregnancy Information
|
|
American College of Obstetricians and
Gynecologists |
|
|
|
| |
|
Ask Lenore |
|
|
Ask Lenore is an information
resource for couples who are expanding their
families via adoption, surrogacy, or traditional
pregnancy as well as those who are experiencing
infertility and/or recurrent miscarriage. |
| |
|
Evidence-Based Prenatal Care: Part I. General
Prenatal Care and Counseling Issues |
|
|
April 1, 2005 - American
Family Physician |
| |
|
Family Planning for Women with Predisposing Risk
Factors for Venous Thrombosis |
|
|
Deborah K. Coon, R.Ph. Pharm.
D. Candidate February 15, 2001 |
| |
|
High Risk Pregnancy Support |
|
|
|
| |
|
Hyperhomocysteinemia, Pregnancy Complications,
and the Timing of Investigation |
|
|
Obstetrics & Gynecology
2004;104:336-343 © 2004 by The American College
of Obstetricians and Gynecologists |
| |
|
Immune treatment 'cuts IVF failures' |
|
|
|
| |
|
Infertility & Reproduction Health Center |
|
|
Infertility problems are
diagnosed in 1 in 10 American couples, yet fully
half eventually bear a child. Find out about
infertility drugs, tests, and treatments such as
IVF. Plus, find daily support in our online
support groups. |
| |
|
InterNational Council on Infertility Information
Dissemination |
|
|
Miscarriage and Perinatal
Loss, Forum Moderated by a Doctor |
| |
|
LABORATORY EVALUATION OF THROMBOPHILIA IN
RECURRENT PREGANCY LOSS |
|
|
In normal pregnancy, levels
of most procoagulant factors (factors VII, VIII,
X, XII, and fibrinogen) rise, while
anticoagulant proteins either remain unchanged
(protein C, antithrombin) or decrease (protein
S). The fibrinolytic system is also altered,
with increased levels of plasminogin activator
inhibitor (PAI). These hemostatic changes can
result in a hypercoagulable state. It has been
postulated that maternal thrombophilic defects
may exaggerate this hemostatic response and lead
to an adverse pregnancy outcome. |
| |
|
Low-Molecular-Weight Heparins in Pregnancy |
|
|
Pharmacotherapy
19(9):1013-1025, 1999. © 1999 Pharmacotherapy
Publications |
| |
|
Management of Recurrent Pregnancy Loss |
|
|
|
| |
|
March of Dimes |
|
|
Our mission is to improve the
health of babies by preventing birth defects,
premature birth, and infant mortality. We carry
out this mission through research, community
services, education and advocacy to save babies'
lives. March of Dimes researchers, volunteers,
educators, outreach workers and advocates work
together to give all babies a fighting chance
against the threats to their health:
prematurity, birth defects, low birthweight. |
| |
|
Minimising the risk of heparin-induced
osteoporosis during pregnancy. |
|
|
Expert Opin Drug Saf. 2005;
4(3):583-90 (ISSN: 1744-764X). |
| |
|
Miscarriage Can Be Prevented |
|
|
|
| |
|
ORGYN Online Magazine |
|
|
Here you can subscribe free
to the ORGYN Online Magazine. This is the online
continuation of ORGYN, Organon's acclaimed and
long-running print magazine read by 120,000
obstetricians and gynecologists worldwide |
| |
|
Parenting & Pregnancy |
|
|
Get information on stages of
pregnancy, signs and symptoms, and pregnancy
tests, or read about parenting styles and
skills, and find parenting tips and advice. |
| |
|
Preeclampsia Foundation |
|
|
Preeclampsia Foundation is a
501 (c) (3) non-profit operating organization
established in the year 2000 to promote safe
pregnancy and post-partum research, public
education and patient support. The Preeclampsia
Foundation's mission is to reduce maternal and
infant illness and death due to preeclampsia by
supporting innovative research, raising public
awareness, and helping women access safe
reproductive technology, support and care.
Because this disorder is transitory in
nature-women become members of a silent club,
each experiencing a similar crisis without the
benefit of emotional, or physical preparation or
the support of women who have been there before. |
| |
|
Preeclampsia May Influence Cancer Risk |
|
|
But Link Between Preeclampsia
and Certain Malignancies Isn't Conclusive |
| |
|
Preeclampsia Signs and Symptoms |
|
|
© 2000 - 2006 Preeclampsia
Foundation |
| |
|
Pregnancy & Arthritis |
|
|
Improved treatment means more
women with all forms of arthritis have a better
chance of having healthy babies. Jane Tadman
reports. |
| |
|
PREGNANCY AND WARFARIN |
|
|
Last modified July 17, 2005 |
| |
|
Pregnancy of a lupus patient--a challenge to the
nephrologist |
|
|
Kong 21 (2) 268 -- Nephrology
Dialysis Transplantation |
| |
|
Pregnancy: Keeping Yourself and Your Baby
Healthy |
|
|
April 1, 2005 - American
Family Physician |
| |
|
Proteinuria in pregnancy: What does it mean? |
|
|
Renal disease and
preeclampsia are your two biggest concerns. An
expert nephrologist outlines the steps involved
in differential diagnosis and management. |
| |
|
Reproductive Immunology Support |
|
|
In this group we will discuss
all patient issues related to Reproductive
Immunology. Topics will include, but are not
limited to, immune related miscarriage,
infertility, IVF failure, pregnancy
complications and "unexplained' pregnancy loss.
We work closely with research pioneer, Dr Alan E
Beer. Our approaches are multiple: to share
experiences, to offer support, to distribute the
latest studies, to record information, to
develop ongoing lists of helpful resources for
the patient. In such spirit, all writing and
documents can be shared. Web access to our group
files at the Yahoo site strongly recommended.
**Please note: Information in this group to be
used for educational purposes only, not to
substitute for medical advice. Please consult
with your physician before undergoing any form
of medical treatment.** |
| |
|
Repromedix - Helping Doctors Help Couples |
|
|
Repromedix is a leading
infertility testing laboratory. The company was
founded in 1994 by life sciences entrepreneur
Craig Sockol. Craig had successfully sold a
business that developed and manufactured kits
for clinical lab testing and was deciding what
to do next. When he and his wife experienced
recurrent pregnancy loss (RPL)—and knowing a bit
about the testing business—he sought help for
their problems. They saw many physicians before
finding one at Harvard Medical who had developed
a new test for RPL. |
| |
|
The Alan E. Beer Center for Reproductive
Immunology & Genetics |
|
|
The Alan E. Beer Center for
Reproductive Immunology & Genetics researches
and treats couples who experience recurrent
miscarriages, multiple pregnancy losses or
repeated in vitro fertilization failures. |
| |
|
The HELLP Syndrome Society, Inc. |
|
|
We are a non-profit
corporation whose mission is to raise awareness
about the condition of HELLP Syndrome, raise
money for research, provide support to families
affected by this condition and conduct research
on the condition. |
| |
|
The Thrombophilias and Pregnancy |
|
|
Victoria Fertility Centre |
| |
|
The Treatment of Lupus in Pregnancy |
|
|
|
| |
|
Thrombophilia in pregnancy: Whom to screen, when
to treat |
|
|
OBG Management, January 2007
· Vol. 19, No. 01. Despite extensive research on
testing and prophylaxis, a cautious approach is
warranted |
| |
|
Thromboprophylaxis with low molecular weight
heparin (Fragmin) in high risk pregnancies. |
|
|
Thromb Haemost. 1997
Jan;77(1):39-43. |
| |
|
Thrombosis in Pregnancy |
|
|
Pregnancy increases the risk
of venous thromboembolism (VTE) but the true
incidence is unknown. The risk of VTE continues
in the post-partum period and is probably higher
than during pregnancy. |
| |
|
Venous Thromboembolism During Pregnancy |
|
|
(c) 2008 American Family
Physician. Provided by ProQuest Information and
Learning. All rights Reserved. |
| |
|
What you need to know about medication safety in
pregnancy |
|
|
Few drugs are major
teratogens, but heightened vigilance is crucial
to protect your pregnant patient. November 2007 |
| |
|
Women's Health- Antiphospholipid Antibody
Syndrome |
|
|
|
| |
|
Top of Page |
|
|
Professional Medical Websites
|
|
Action Research Overcoming Disease and
Disability |
|
|
|
| |
|
American Academy of Dermatology |
|
|
|
| |
|
American Academy of Pain Medicine (AAPM) |
|
|
The American Academy of Pain
Medicine (AAPM) is the medical specialty society
representing physicians practicing in the field
of Pain Medicine. As a medical specialty
society, the Academy is involved in education,
training, advocacy, and research in the
specialty of Pain Medicine. |
| |
|
American Academy of Pediatrics |
|
|
|
| |
|
American Association of Surgical Physicans
Assistants |
|
|
Welcome aboard the official
website of the American Association of Surgical
PAs! AASPA is the premier multi-speciality
organization representing all PA that work in
the pre-operative, intra-operative, and
post-operative settings. AASPAs operational goal
is to be all things for all surgical PAs! We
also represent PAs in training, both students
and PA residents in a wide variety of academic
and educational settings. We are also proud to
offer one of the most active programs for pre-PA
students. |
| |
|
American College of Obstetricians and
Gynecologists |
|
|
ACOG works primarily in four
areas: Serving as a strong advocate for quality
health care for women; Maintaining the highest
standards of clinical practice and continuing
education for its membersl; Promoting patient
education and stimulating patient understanding
of and involvement in medical care; Increasing
awareness among its members and the public of
the changing issues facing women's health care. |
| |
|
American College of Rheumatology |
|
|
|
| |
|
American Dietetic Association |
|
|
800-877-1600 ext. 5000 |
| |
|
American Society for Reproductive Medicine
(ASRM) |
|
|
ASRM is a voluntary,
non-profit organization devoted to advancing
knowledge and expertise in reproductive
medicine, including infertility, menopause,
contraception, and sexuality. |
| |
|
American Society of Hematology (ASH) |
|
|
In April 1958, the first
official ASH meeting was held in Atlantic City,
NJ, where more than 300 hematologists gathered
to discuss clinical and research matters related
to blood and blood diseases. Since that initial
meeting, ASH has played an active and important
role in the development of hematology as a
discipline. For the past four decades, ASH has
sponsored its annual meeting, the premier annual
education and scientific event in the field of
hematology, and has published Blood, the Journal
of the American Society of Hematology, which is
the most cited peer-reviewed publication in the
field. |
| |
|
Health SCOUT |
|
|
|
| |
|
Health Web .org |
|
|
Medical Website |
| |
|
Hemex laboratories |
|
|
This is a link for Hemex
Labs. They have a wonderful website on "New
bloodtests" for detecting coagulopathies and
offer some interesting publications on testing
and research. |
| |
|
Lab Tests Online |
|
|
Lab Tests Online has
completed its 2004 survey of leading medical and
health organizations to update its screening
information. Located under the "Screening" menu
and organized by age and condition, these pages
identify current screening recommendations from
well-regarded sources and help users to
distinguish among the differences in opinion. Go
straight to the menu, or start with the article,
Staying Healthy in an Era of Patient
Responsibility. |
| |
|
Medic Direct UK |
|
|
|
| |
|
Medical Search Engine |
|
|
|
| |
|
National Center for Biotechnological Information |
|
|
Established in 1988 as a
national resource for molecular biology
information, NCBI creates public databases,
conducts research in computational biology,
develops software tools for analyzing genome
data, and disseminates biomedical information -
all for the better understanding of molecular
processes affecting human health and disease. |
| |
|
National Heart, Lung & Blood Institute |
|
|
|
| |
|
National Institutes of Health |
|
|
A-Z index of NIH health
resources, clinical trials, health hotlines,
MEDLINEplus, drug information |
| |
|
National Library of Medicine (NLM) |
|
|
The National Library of
Medicine (NLM) Web site has a page for locating
libraries in your area that can provide direct
access to journals (print or online) or where
you can get articles through interlibrary loan
and Loansome Doc (an NLM document-ordering
service). You can access this page at the
following link. |
| |
|
Net Doctor |
|
|
In the UK |
| |
|
Office of Rare Diseases |
|
|
This Web site provides
information about ORD-sponsored biomedical
research, scientific conferences, rare and
genetic diseases in English and Spanish (Genetic
and Rare Diseases Information Center), and a
portal to information on major topics of
interest in the rare diseases community. |
| |
|
Online Mendelian Inheritance in Man (OMIM) |
|
|
Online Mendelian Inheritance
in Man (OMIM) may be a useful resource. OMIM is
an electronic catalog of human genes and genetic
disorders. The Web site was developed by the
National Center for Biotechnology Information
(NCBI) and contains text and reference
information. It also contains links to MEDLINE,
another electronic database of medical and
research articles. Although the language is
technical, OMIM is considered a comprehensive
source of information. Based on the complex
information found in OMIM, you may benefit from
discussing its contents with a medical
professional. Click on the following link for
the OMIM page on APS. |
| |
|
Rare Disease Clinical Research Network |
|
|
You can take action! Once you
have reached the correct consortium, you will be
able to join the contact registry for clinical
research trials. You will also find several
helpful resources that include participating
clinical center information, self help and
advocacy group information and other useful
links. |
| |
|
Rare Thrombotic Diseases Consortium |
|
|
The Duke Hemostasis &
Thrombosis Center is a multidisciplinary program
devoted to improving the care of patients with
bleeding and clotting disorders through
innovative basic and clinical research efforts.
The Center was formed in 2001, when it was
selected by the Centers for Disease Control &
Prevention to be one of eight pilot Hemostasis &
Thrombosis Centers in the United States .
Leadership of the program includes faculty in
Hematology, Maternal-Fetal Medicine, Pediatric
Hematology, and Cardiology. Ongoing clinical
research trials are investigating the optimal
'dose' of platelets for replacement therapy, the
role of inherited hypercoagulable states in
intrauterine growth restriction, and therapeutic
strategies for patients with end-stage renal
disease and recurrent vascular access
occlusions. |
| |
|
Society for Maternal-Fetal Medicine (SMFM) |
|
|
Established in 1977, the
Society for Maternal-Fetal Medicine (SMFM) is a
not-for-profit organization of over 2,000
members that are dedicated to improving
perinatal care. The Society's primary objectives
are to promote and expand education in
Maternal-Fetal medicine and to encourage the
exchange of new ideas and research concerning
the most recent approaches and treatments for
obstetrical problems. A Maternal-Fetal medicine
specialist is an obstetrician/gynecologist who
has completed two to three years of additional
formal education and clinical experience within
the an American Board of Obstetrics and
Gynecology (ABOG) approved Maternal-Fetal
Medicine Fellowship Program. Members of the
Society have advanced knowledge of the
obstetrical, medical, genetic, and surgical
complications of pregnancy and their effects on
both the mother and fetus. |
| |
|
The National Women's Health Information Center |
|
|
|
| |
|
Trip Medical Database |
|
|
Welcome to the TRIP Database,
one of the Internet's leading medical resources.
The TRIP Database allows users to rapidly and
easily identify high quality medical literature
from a wide range of sources. |
| |
|
Veritas Medicine |
|
|
Veritas Medicine is a free
confidential resource providing access to
clinical trials and information on treatment
options. |
| |
|
Web MD |
|
|
|
| |
|
Welcome to the Department of Health |
|
|
Providing health and social
care policy, guidance and publications |
| |
|
Top of Page |
|
|
Stroke & TIA Information
|
|
'My son had a stroke aged three' |
|
|
Last Updated: Saturday, 20
August 2005, 01:36 GMT 02:36 UK |
| |
|
6th International Conference on Stroke |
|
|
This website will be
constantly updated! |
| |
|
A New Paradigm for Stroke Prevention |
|
|
April 2005 Stroke is the
third leading cause of death in the US.
Fortunately, diagnostic imaging for stroke risk
and stroke-prevention strategies have advanced
greatly in recent years. It is now possible to
reduce the artery-clogging plaque that leads to
stroke, offering hope that this debilitating
condition can be prevented. |
| |
|
American Stroke Association |
|
|
A Division of the American
Heart Association. They have a good Stroke
Connection Magazine. |
| |
|
An overview of transient ischaemic attack. |
|
|
Nursing Standard. 21, 14-16,
50-57. Date of acceptance: August 1 2006. This
article provides an overview of transient
ischaemic attack (TIA). It discusses the
clinical presentation of TIA, its significance
as a marker of vascular risk, key diagnostic
interventions and management strategies. Trends
and challenges in service provision and the
roles of specialist and general nurses in
managing patients with TIA are explored. |
| |
|
An Update on Transient Ischemic Attacks |
|
|
J Neurosci Nurs.
2005;37(5):243-248. ©2005 American Association
of Neuroscience Nurses Posted 11/01/2005 |
| |
|
Aspirin Beats Coumadin for Brain Blockage |
|
|
Despite Treatment, Brain
Artery Narrowing Still Deadly |
| |
|
Aspirin plus dipyridamole is better than aspirin
alone for cerebral ischemia |
|
|
The ESPRIT Study Group;
Halkes PH, van Gijn J, Kappelle LJ, Koudstaal
PJ, Algra A. Aspirin plus dipyridamole versus
aspirin alone after cerebral ischaemia of
arterial origin (ESPRIT): randomised controlled
trial. Lancet 2006; 367:1665–1673. |
| |
|
Brain Attack Coalition |
|
|
The Brain Attack Coalition is
a group of professional, voluntary and
governmental entities dedicated to reducing the
occurrence, disabilities and death associated
with stroke. The goal of the Coalition is to
strengthen and promote the relationships among
its member organizations in order to help stroke
patients or those who are at risk for a stroke. |
| |
|
Brain Basics: Preventing Stroke |
|
|
NINDS health-related material
is provided for information purposes only and
does not necessarily represent endorsement by or
an official position of the National Institute
of Neurological Disorders and Stroke or any
other Federal agency. Advice on the treatment or
care of an individual patient should be obtained
through consultation with a physician who has
examined that patient or is familiar with that
patient's medical history. All NINDS-prepared
information is in the public domain and may be
freely copied. Credit to the NINDS or the NIH is
appreciated. Last updated June 10, 2005 |
| |
|
Cerebrovascular Diseases, Stroke |
|
|
Internet Handbook of
Neurology |
| |
|
Chiropractic's Dirty Secret: Neck Manipulation
and Strokes |
|
|
Stroke from chiropractic neck
manipulation occurs when an artery to the brain
ruptures or becomes blocked as a result of being
stretched. The injury often results from extreme
rotation in which the practitioner's hands are
placed on the patient's head in order to rotate
the cervical spine by rotating the head. The
vertebral artery, whch is shown in the picture
to the right, is vulnerable because it winds
around the topmost cervical vertebra (atlas) to
enter the skull, so that any abrupt rotation may
stretch the artery and tear its delicate lining.
The anatomical problem is illustrated on page 7
of The Chiropractic Report, July 1999. A blood
clot formed over the injured area may
subsequently be dislodged and block a smaller
artery that supplies the brain. Less frequently,
the vessel may be blocked by blood that collects
in the vessel wall at the site of the
dissection. This article was revised on July 2,
2006. |
| |
|
Dizziness due to TIA and Stroke |
|
|
Transient ischemic attacks or
TIA's are brief episodes of neurological
disturbance caused by reduced blood supply to an
area of the brain. Strokes are longer lasting
neurological disturbance, associated with
permanent damage to the brain. This document
discusses TIA's and strokes associated with
dizziness, also known as Vertebrobasilar TIA's
and Strokes. These strokes are from blockages of
one or more of the arteries shown on the the
picture to the right (Posterior Inferior
Cerebellar Artery or PICA, vertebral arteries,
anterior inferior cerebellar arteries or AICA,
basilar artery, superior cerebellar artery or
SCA). |
| |
|
Drug 'may cut stroke disability' |
|
|
Scientists hope a new drug
could cut the risk of serious disability
following a stroke. Last Updated: Thursday, 9
February 2006, 11:35 GMT |
| |
|
Duration of hospital participation in a
nationwide stroke registry is associated with
improved quality of care |
|
|
BMC Neurology 2006, 6:20.
doi:10.1186/1471-2377-6-20. Conclusion: In a
large cohort of patients with stroke or TIA,
three targeted quality-improvement measures
improved among hospitals participating in a
disease-specific registry. Although the changes
could be attributed to interventions other than
the registry, these findings demonstrate the
potential for hospital-level interventions to
improve care for patients with stroke and TIA. |
| |
|
Electrocardiographic changes in patients with
acute stroke in the prehospital setting and
their prognostic importance |
|
|
Critical Care 2006, 10(Suppl
1):P457 doi:10.1186/cc4804. Conclusion: ECG
abnormalities are frequent in acute stroke and
may predict 6-month mortality. The observations
of this study suggest differences between the IS
and HS group. The ECG evaluation of patients
with acute stroke must be started at the field.
Whether the ECG changes are the result of some
generalized atherosclerosis that promotes acute
stroke, or the magnitude and perhaps location of
brain infarction promotes ECG changes in the
reverse direction, remains the question. |
| |
|
European Stroke Initiative |
|
|
Information and Links |
| |
|
Guidelines for the Early Management of Adults
With Ischemic Stroke |
|
|
Stroke. 2007;38:1655. © 2007
American Heart Association, Inc. Management of
patients with acute ischemic stroke remains
multifaceted and includes several aspects of
care that have not been tested in clinical
trials. This statement includes recommendations
for management from the first contact by
emergency medical services personnel through
initial admission to the hospital. Intravenous
administration of recombinant tissue plasminogen
activator remains the most beneficial proven
intervention for emergency treatment of stroke.
Several interventions, including intra-arterial
administration of thrombolytic agents and
mechanical interventions, show promise. Because
many of the recommendations are based on limited
data, additional research on treatment of acute
ischemic stroke is needed. |
| |
|
Hypercoagulation Testing in Ischemic Stroke |
|
|
Arch Pathol Lab Med—Vol 131,
June 2007. Conclusions: Certain tests, such as
C-reactive protein, homocysteine,
antiphospholipid antibodies, and lipoprotein(a),
may be useful in patients with a history of
stroke or at high risk for stroke, as evidenced
by prospective data. Factor V Leiden,
prothrombin G20210A, protein C, protein S, and
antithrombin are not recommended for routine
testing but may be useful in certain
populations, such as in pediatric patients or in
patients with cerebral vein thrombosis. |
| |
|
Imaging in Transient Ischemic Attacks/Acute
Stroke--Transient Monocular Blindness |
|
|
Stroke. 1997;28:1480-1497. |
| |
|
Is this a vascular event? |
|
|
A cerebrovascular event
traditionally has been used to describe the
pathophysiologic entities of reversible
ischaemia, infarction or haemorrhage of the
central nervous system. Mechanisms of cerebral
ischaemia include arterial embolism, thrombosis,
thromboembolism, small vessel disease and
haemodynamic disturbances that may involve a
myriad of different blood vessels of different
sizes. These processes may be a consequence of
hypertension, diabetes, atherosclerosis,
valvular heart disease, cardiac dysrhythmias or
cardiac wall motion dysfunction. Uncommon causes
include vasculitides, coagulation disorders,
atrial myxoma and paradoxical embolism. Rarely
venous infarction of the brain may occur as a
consequence of venous or sinus thrombosis.
Haemorrhage may occur into the subarachnoid or
subdural space or within the brain parenchyma
and may be due to hypertension, aneurysms,
vascular malformations, trauma, coagulopathies
or occur without clear cause. |
| |
|
Let’s Talk About Emotional Changes After Stroke |
|
|
Immediately after a stroke, a
survivor may respond one way, yet weeks later
respond entirely differently. Some survivors may
react with understandable sadness; others may be
amazingly cheerful. These emotional reactions
may occur because of biological causes due to
stroke or because of the effects of a stroke
(psychological causes). These changes may vary
with time and can interfere with rehabilitation. |
| |
|
Lipoprotein(a) and Incident Ischemic Stroke |
|
|
Stroke. 2006;37:1407.
Conclusions— A high Lp(a) concentration is
associated with a higher incidence of ischemic
stroke in blacks and white women, but not in
white men. |
| |
|
Med Help International |
|
|
Links and information about
strokes |
| |
|
Mobility problems may be result of tiny strokes |
|
|
Published: Sunday, Feb. 5,
2006. Registration is required to view this
article. |
| |
|
National Clinical Guidelines for Stroke |
|
|
June 2004 |
| |
|
National Institute of Neurological Disorders and
Stroke (NINDS) |
|
|
The nation's leading
supporter of biomedical research on disorders of
the brain and nervous system |
| |
|
National Stroke Association |
|
|
National Stroke Association
is reaching new heights in stroke. As the
preeminent organization committed to fighting
stroke in this country, NSA is providing
unprecedented national expertise and leadership
for those at risk, suffering or recovering from
this devastating condition. |
| |
|
National Stroke Association Information on
Stroke Prevention, Stroke Risk Factors, Stroke
Symptoms, and Stroke Recovery |
|
|
National Stroke Association
is the only national organization in the United
States that focuses 100% of its efforts on
stroke. NSA achieves its mission to lower the
incidence and impact of stroke by developing
compelling community outreach programs, calling
for continued improvement in the quality of
stroke patient care, and educating both
healthcare professionals and the general public
about stroke. Established in 1984, NSA has never
lost sight of its vision to reach as many
individuals as possible and be a beacon of hope
for stroke survivors. We strive every day to
increase public awareness about stroke
prevention, symptom recognition, treatment
options and rehabilitation. |
| |
|
Pathophysiology and classification of stroke. |
|
|
Collins C (2007) Nursing
Standard. 21, 28, 35-39. Date of acceptance:
January 18 2007. |
| |
|
Pediatric Stroke |
|
|
|
| |
|
Pediatric strokes puzzling but not rare |
|
|
Although there is scant
information on childhood strokes, the same rapid
diagnosis promoted for adults should help save
young brains. |
| |
|
Primary Prevention of Ischemic Stroke |
|
|
Stroke. 2006;37:1583. A
Guideline From the American Heart
Association/American Stroke Association Stroke
Council: Cosponsored by the Atherosclerotic
Peripheral Vascular Disease Interdisciplinary
Working Group; Cardiovascular Nursing Council;
Clinical Cardiology Council; Nutrition, Physical
Activity, and Metabolism Council; and the
Quality of Care and Outcomes Research
Interdisciplinary Working Group: The American
Academy of Neurology affirms the value of this
guideline. |
| |
|
Primary Prevention of Ischemic Stroke |
|
|
Stroke. 2006;37:1583. © 2006
American Heart Association, Inc. A Guideline
From the American Heart Association/American
Stroke Association Stroke Council: Cosponsored
by the Atherosclerotic Peripheral Vascular
Disease Interdisciplinary Working Group;
Cardiovascular Nursing Council; Clinical
Cardiology Council; Nutrition, Physical
Activity, and Metabolism Council; and the
Quality of Care and Outcomes Research
Interdisciplinary Working Group: The American
Academy of Neurology affirms the value of this
guideline. Conclusion— Extensive evidence is
available identifying a variety of specific
factors that increase the risk of a first stroke
and providing strategies for reducing that risk. |
| |
|
Primary Stroke Prevention |
|
|
AJN, American Journal of
Nursing, November 2006, Volume 106 Number 11,
Pages 40 - 49. |
| |
|
Reversible ischemic neurologic deficit: Is it a
stroke? |
|
|
Reversible ischemic
neurologic deficit (RIND) occurs when blood flow
to your brain is temporarily restricted. Doctors
consider it a minor ischemic stroke, or
mini-stroke. RIND increases your risk of a
subsequent major stroke. Updated: 09/26/2005 |
| |
|
Short-term prognosis after a TIA: A simple score
predicts risk |
|
|
|
| |
|
Should patients with TIAs be hospitalized? |
|
|
Both TIA and stroke are
markers of impending disability TIAs ARE NOT
BENIGN DERK W. KRIEGER, MD Section of Stroke and
Neurological Intensive Care, The Cleveland
Clinic Foundation |
| |
|
Spontaneous Early Improvement Following Ischemic
Stroke |
|
|
Stroke. 1995;26:1358-1360. ©
1995 American Heart Association, Inc.
Conclusions: Early spontaneous improvement after
ischemic stroke may occur in a substantial
proportion of patients and more commonly after
lacunar stroke. Even so, the majority of
patients with acutely disabling stroke will
remain significantly impaired 1 week after
stroke onset. |
| |
|
Stroke Care Australia |
|
|
|
| |
|
Stroke Health Center |
|
|
Stroke strikes about 700,000
Americans each year, but the vast majority of
people survive. Close to 5 million stroke
survivors are managing their health today. Here
you'll find in-depth articles on stroke
symptoms, treatments, and prevention. Plus, get
daily support in our online support group. |
| |
|
Stroke Network |
|
|
Information and support |
| |
|
Stroke Occur in Children Too |
|
|
Strokes are usually
associated with the very old, not the very
young. However, strokes occur in children more
frequently than brain tumours, at a rate of
three per 100,000 children in Canada annually. |
| |
|
Stroke Support for Young People and Children |
|
|
Has links and a message board |
| |
|
Stroke Survivors International |
|
|
Information and on-line
stroke support group |
| |
|
Stroke Warning Signs Often Occur Hours Or Days
Before Attack |
|
|
|
| |
|
Stroke: The clot that changes lives |
|
|
Men in Nursing, October 2006,
Volume 1 Number 5, Pages 18 - 27 |
| |
|
Strokes ignorance 'costing lives' |
|
|
Lives are being lost because
of a "worrying" lack of awareness in the UK
about strokes, campaigners say. Last Updated:
Saturday, 4 February 2006, 01:24 GMT |
| |
|
The Claim: A Stroke Can Be Diagnosed in Three
Steps |
|
|
|
| |
|
The Stroke Association (UK) |
|
|
|
| |
|
The Stroke Foundation New Zealand |
|
|
|
| |
|
Thrombolysis for Acute Ischemic Stroke |
|
|
June 2005 Ischemic stroke is
the most common type of stroke accounting for
about 40,000 cases annually in Canada. In the
great majority of cases, the cause is an acute
occlusion of intracerebral arteries caused by
thrombus originating either from proximal
arterial atherothrombotic lesions or from an
intracardiac source. Because thrombolytic
therapy has been shown to restore vessel patency
rapidly in different vascular beds, its use in
acute cerebral ischemia appears reasonable as
the brain is particularly sensitive to ischemia.
Although several drugs (tissue plasminogen
activator, urokinase, pro-urokinase,
streptokinase) have been tested in this clinical
context, only tissue plasminogen activator
(t-PA) has been approved for treatment of acute
ischemic stroke in Canada. |
| |
|
Transient Ischemic Attack |
|
|
|
| |
|
Transient ischemic attack (TIA) |
|
|
A transient ischemic attack
is a "mini-stroke" caused by temporary
disturbance of blood supply to an area of the
brain, resulting in a sudden, brief decrease in
brain function. (It lasts less than 24 hours,
usually less than one hour). |
| |
|
Transient Ischemic Attack (TIA) Information Page |
|
|
|
| |
|
Transient Ischemic Attacks |
|
|
Signs, Symptoms, and Risk
Factors in Ischemic Stroke. US Pharmacist Vol.
No: 28:10 Posted: 10/15/03 |
| |
|
TRANSIENT ISCHEMIC ATTACKS (TIA) |
|
|
A TIA is a small stroke or
local bad circulation in the brain that lasts a
short time without cerebral infarction, or a
small brain infarction with rapid clinical
recovery. TIA's are reversible focal
neurological deficits persisting for less than
24 hours but usually the duration is a matter of
minutes rather than hours. In a cooperative
study, the median duration of carotid TIA's was
found to be fourteen minutes and of
vertebrobasilar events eight minutes. Ninety per
cent of carotid TIA's lasted less than six
hours, and ninety per cent of vertebrobasilar
TIA's lasted less than two hours. |
| |
|
Transient ischemic attacks and prolonged
reversible ischemic neurologic deficit.
Diagnosis, differential diagnosis and treatment |
|
|
Schweiz Rundsch Med Prax.
2000 Mar 23;89(13):542-8. |
| |
|
Transient Ischemic Attacks: Part I. Diagnosis
and Evaluation |
|
|
Transient ischemic attack is
no longer considered a benign event but, rather,
a critical harbinger of impending stroke.
Failure to quickly recognize and evaluate this
warning sign could mean missing an opportunity
to prevent permanent disability or death. The
90-day risk of stroke after a transient ischemic
attack has been estimated to be approximately 10
percent, with one half of strokes occurring
within the first two days of the attack. The
90-day stroke risk is even higher when a
transient ischemic attack results from internal
carotid artery stenosis. Most patients reporting
symptoms of transient ischemic attack should be
sent to an emergency department. Patients who
arrive at the emergency department within 180
minutes of symptom onset should undergo an
expedited history and physical examination, as
well as selected laboratory tests, to determine
if they are candidates for thrombolytic therapy.
Initial testing should include complete blood
count with platelet count, prothrombin time,
International Normalized Ratio, partial
thromboplastin time, and electrolyte and glucose
levels. Computed tomographic scanning of the
head should be performed immediately to ensure
that there is no evidence of brain hemorrhage or
mass. A transient ischemic attack can be
misdiagnosed as migraine, seizure, peripheral
neuropathy, or anxiety. (Am Fam Physician
2004;69:1665-74,1679-80. Copyright© 2004
American Academy of Family Physicians.) |
| |
|
Transient Ischemic Attacks: Part II. Treatment |
|
|
Risk factors for stroke
should be evaluated in patients who have had a
transient ischemic attack. Blood pressure, lipid
levels, and diabetes mellitus should be
controlled. When applicable, smoking cessation
and weight loss also are important.
Angiotensin-converting enzyme inhibitor therapy
may help prevent stroke. Aspirin is the
treatment of choice for stroke prevention in
patients who do not require anticoagulation.
Clopidogrel is an alternative therapy in
patients who do not tolerate aspirin. Atrial
fibrillation, a known cardioembolic source
(confirmed thrombus), or a highly suspected
cardioembolic source (e.g., recent large
myocardial infarction, dilated cardiomyopathy,
mechanical valve, rheumatic mitral valve
stenosis) are indications for anticoagulation.
(Am Fam Physician 2004;69:1681-8. Copyright©
2004 American Academy of Family Physicians.) |
| |
|
Turning a stroke into a TIA: curative
thrombolysis with combined intravenous and
intra-arterial tPA |
|
|
Can J Emerg Med
2006;8(1):54-7. Conclusions: Many centres are
gaining experience using the combined IV-IA
thrombolytic approach as a treatment option for
carefully selected individuals with severe acute
ischemic stroke, although it remains an
investigational procedure that awaits further
study in randomized trials. |
| |
|
Vertebrobasilar Atherothrombotic Disease |
|
|
Vertebrobasilar
atherothrombotic disease (VBATD) describes a
wide spectrum of clinical entities with a common
pathophysiology. Transient ischemic attacks
(TIAs) in this vascular territory are also
referred to as vertebrobasilar insufficiency
(VBI). This more commonly used term developed in
the 1950s after Fisher introduced the term
carotid insufficiency to describe TIAs of the
anterior circulation, which frequently serve as
the prodrome to carotid branch infarcts.
Although carotid insufficiency has been dropped
from common medical jargon, VBI persists as the
term that encompasses all TIA syndromes of the
posterior circulation. In this article, VBATD
describes both transient and permanent ischemic
deficits as they affect posterior cerebral
circulation. Last Updated: July 2, 2004 |
| |
|
Vertebrobasilar TIA |
|
|
Vertebro-basilar artery TIA's
- account for about 7% of TIAs - clinical
features are more diverse than those that may
occur in carotid artery TIA's. |
| |
|
What is a stroke? What is a TIA? |
|
|
Please note: This information
was as current as we could make it on the date
given above. But medical information is always
changing, and some information given here may be
out of date. For regularly updated information
on a variety of health topics, please visit
familydoctor.org, the AAFP patient education Web
site. Copyright © 2004 by the American Academy
of Family Physicians |
| |
|
WHAT IS YOUR RISK OF A MAJOR STROKE IF YOU HAVE
HAD A TRANSIENT ISCHEMIC ATTACK (TIA) OR A MINOR
STROKE |
|
|
Last updated August 29, 2004 |
| |
|
Workshop on Perinatal and Childhood Stroke |
|
|
Report of the National
Institutes of Neurological Disorders and Stroke
Workshop on Perinatal and Childhood Stroke
September 18 and 19th, 2000 Bethesda, MD |
| |
|
Top of Page |
|
|
Supports INR Greater Than 3
|
|
About thrombosis: thrombophilia: acquired
thrombophilia: APS |
|
|
This article supports an INR
of 3.0 to 4.0 for APS patients. |
| |
|
Antiphospholipid antibodies syndrome in 'Stroke
in young'. |
|
|
Mehndiratta MM, Bhattacharya
A, Gupta M, Khawaja GK, Puri V. Antiphospholipid
antibodies syndrome in 'Stroke in young'. Neurol
India 1999;47:122-6 Promotes an INR of greater
than 3.0. |
| |
|
Antiphospholipid Antibody Syndrome |
|
|
Indian Pediatrics 2001; 38:
1413-1416 Promotes an INR of greater that 3.0. |
| |
|
Antiphospholipid Antibody Syndrome (APS) |
|
|
Promotes an INR of greater
than 3.0. |
| |
|
Antiphospholipid Syndrome |
|
|
by Erik Letko, M.D. Promotes
an INR of greater that 3.0. |
| |
|
Antiphospholipid syndrome |
|
|
EMIS is grateful to Dr Paul
Hewish for authoring this article. The final
copy has passed peer review of the independent
Mentor GP authoring team. ©EMIS 2004. Promotes
an INR of 3.5 or greater. |
| |
|
Antiphospholipid Syndrome |
|
|
Promotes an INR of 3.5 or
greater. |
| |
|
Antiphospholipids & SLE: A Clinical Overview |
|
|
Dr. Graham R.V. Hughes, MD
FRCP The Rayne Institute St. Thomas' Hospital,
London. The study led by Dr. Munther Khamashta
and colleagues in the unit showed that over a 10
year period, neither aspirin nor low dose
warfarin (INR |
| |
|
eMedicine - Antiphospholipid Syndrome : Article
by Steven Carsons, MD |
|
|
Last Updated: December 5,
2004 Based on the most recent evidence, a
reasonable target for the international
normalized ratio (INR) is 2.6-3 for a minimum of
6 months for a first thrombosis. Patients with
recurrent thrombotic events while well
maintained on the above regimen may require an
INR of 3-4 and generally receive anticoagulation
therapy for life. For severe or refractory
cases, a combination of warfarin and aspirin may
be used. |
| |
|
Heart Valve Involvement (Libman-Sacks
Endocarditis) in the Antiphospholipid Syndrome |
|
|
(Circulation.
1996;93:1579-1587.) © 1996 American Heart
Association, Inc. Promotes an INR of greater
than 3.0. |
| |
|
Hughes syndrome crosses boundaries |
|
|
Autoimmunity Reviews Volume
1, Issues 1-2 , February 2002, Pages 43-48.
Take-home message: Hughes syndrome or APS is
characterised by the presence of recurrent
thrombosis and obstetric complications in
association with aPL in patients’ serum;
β2GPI-dependent ELISA for aCL and LA are the
only aPL recommended for routine testing and
diagnosis of patients with APS due to their good
level of standardisation and clinical
correlations. Antibodies directed to other
phospholipids or phospholipid-binding proteins
(such as phosphatidylserine, β2GPI, prothrombin,
protein C, etc.) are likely to have clinical
significance although the test for their
detection and clinical role are less well
defined; Persistent positivity of aCL at medium
to high levels and/or LA are required for the
diagnosis of definite APS; APS is unique among
thrombophilias in producing both arterial and
venous thrombosis with similar frequency;
Pregnancy complications are one of the hallmarks
of APS. Fetal loss are most typical, but
recurrent early miscarriage, prematurity due to
placental insufficiency and pre-eclampsia are
also frequent; A number of neurological
diseases, such as MS-like disease, cognitive
impairment and certain forms of migraine are
being investigated as possible manifestations of
Hughes syndrome; Current evidence, mostly from
retrospective series, points to prolonged oral
anticoagulation at a target INR 3.5 as the
treatment of choice in aPL-associated
thrombosis. Individual patients at lower risk of
thrombosis or higher risk of bleeding may
receive less intensive anticoagulation; Aspirin
and heparin are recommended as treatments for
pregnancy complications, although the optimal
combination of both drugs is still to be
defined. Recommendations vary among different
groups; Corticosteroids do not play any role in
treatment of manifestations of APS other than
thrombocytopenia, haemolytic anaemia and
catastrophic APS. |
| |
|
Listen to the Patient — Anticoagulation Is
Critical in the Antiphospholipid (Hughes)
Syndrome |
|
|
© 2003. The Journal of
Rheumatology Publishing Company Limited.
Supports an INR of greater than 3.0. |
| |
|
Migraine, memory loss, and "multiple sclerosis
". Neurological features of the antiphospholipid
(Hughes’) syndrome |
|
|
Postgraduate Medical Journal
2003;79:81-83 © 2003 Fellowship of Postgraduate
Medicine. Promotes an INR of greater than 3.0. |
| |
|
Testing for and Clinical Significance of
Anticardiolipin Antibodies |
|
|
Clinical and Diagnostic
Laboratory Immunology, November 1999, p.
775-782, Vol. 6, No. 6 1071-412X/99/$04.00+0
Copyright © 1999, American Society for
Microbiology. All rights reserved.
Anticoagulation with coumarins to an
international normalized ratio (INR) of 2 to 3,
standard after an episode of venous
thromboembolism, appears inadequate in APS, and
a target INR level of 2.5 to 4.0 or >3.0 has
been suggested, although the risk of hemorrhage
is increased. |
| |
|
The Antiphospholipid Syndrome |
|
|
Most patients with venous or
arterial thrombosis and APS do well with
conventional warfarin treatment (target INR 2.0
- 3.0). It is recommended that patients with
recurrent thrombosis despite conventional doses
of warfarin should maintain an INR of 3.0 - 4.0.
This recommendation is based on one descriptive
study and requires confirmation by randomised
trials. The benefit of adding aspirin in
arterial disease is not clear, and is likely to
increase the risk of bleeding. |
| |
|
The antiphospholipid syndrome. |
|
|
Natl Med J India. 2003
Nov-Dec;16(6):311-6. Promotes an INR of 3-4. |
| |
|
The Management of Thrombosis in the
Antiphospholipid-Antibody Syndrome |
|
|
N. Engl. J. Med. 332:993-997
April 1995 Conclusions: The risk of recurrent
thrombosis in patients with the
antiphospholipid-antibody syndrome is high.
Long-term anticoagulation therapy in which the
international normalized ratio is maintained at
or above 3 is advisable in these patients. |
| |
|
Thrombophilia: What's a Practitioner to Do? |
|
|
Hematology 2001 © 2001 The
American Society of Hematology. Patients with
spontaneous thromboembolism and the aPL syndrome
should be treated with long-term oral
anticoagulant therapy. Results of studies vary
as to the recommended intensity of anticoagulant
therapy. A retrospective study concluded that an
international normalized ratio (INR) of > 3.0
was necessary to protect patients from
recurrence of venous or arterial thrombosis. |
| |
|
Treatment of Systemic Lupus Erythematosus: An
Update |
|
|
This article suggests an INR
of 3 to 4 for patients with APS. Dr. Petri is
one of the leading APS specialists and this
webpage would be good to show your doctor if you
are having a problem getting him/her to take you
seriously that our INRs need to be higher. |
| |
|
Warfarin in Antiphospholipid Syndrome — Time to
Explore New Horizons |
|
|
The Journal of Rheumatology
Feb. 2005 Promotes an INR of greater than 3.0. |
| |
|
Warfarin Therapy: Evolving Strategies in
Anticoagulation |
|
|
Published in the American
Family Physician, Feb. 1999. A good general
article, promotes an INR of 3-4 for APS
patients. |
| |
|
Top of Page |
|
|
Thrombosis Information - *General
|
|
Air Travel and thrombophilia |
|
|
Last Updated: 2/15/2004 |
| |
|
Airhealth.org |
|
|
How to avoid Economy Class
Syndrome (blood clots resulting from lengthy
plane trips). |
| |
|
American Thrombosis Association |
|
|
|
| |
|
Anticoagulation Forum |
|
|
Gives Anticoagulation Clinics
Locations |
| |
|
Arterial clots and factor V Leiden or other
thrombophilias |
|
|
Antiphospholipid antibodies
can cause both, arterial and venous blood clots. |
| |
|
Blood Clotting |
|
|
Diagram and Explanation of
blood factors, proteins and drug effects |
| |
|
Blood Online |
|
|
Journal of the American
Society of Hematolgy |
| |
|
ClotCare |
|
|
ClotCare strives to help
others improve lives by providing both patients
and healthcare providers with the most
up-to-date information and expert insight on
optimal use of antithrombotic and anticoagulant
therapy. In achieving this end, ClotCare seeks
to be the premier source to which patients and
clinicians turn to get information on these
therapies used to prevent and/or treat unwanted
blood clots that cause heart attacks, strokes,
and other potentially catastrophic events. |
| |
|
Clots, Articles, Support Groups and Resources |
|
|
|
| |
|
D-dimer |
|
|
D-dimer is a blood test
performed in the medical laboratory to diagnose
thrombosis. Since its introduction in the 1990s,
it has become an important test performed in
patients suspected of thrombotic disorders.
While a negative result practically rules out
thrombosis, a positive result can indicate
thrombosis but also has other potential causes.
Its main use, therefore, is to exclude
thromboembolic disease where the probability is
low. |
| |
|
Dallas Thrombosis Hemostasis and Difficult
Hematology Clinical Centre |
|
|
Copyright © 1996-2006 Dallas
Thrombosis Hemostasis Clinical Center |
| |
|
DMOZ.org: Thrombosis Links |
|
|
Directory of links to
thrombosis-related sites |
| |
|
Genetics of thrombophilia |
|
|
Last Updated: 2/15/2004 |
| |
|
Hematology Resource Page |
|
|
University of Illinois -
Urbana/Champaign |
| |
|
Hemex Laboratories |
|
|
A National Leader in
Coagulation and Flow Cytometry/ Special
Hematology |
| |
|
High Altitude and Clotting Risk |
|
|
|
| |
|
HosLink CoagPage |
|
|
Lots of excellent links |
| |
|
Hypercoagulability: Too Many Tests, Too Much
Conflicting Data |
|
|
Hematology 2002 © 2002 The
American Society of Hematology |
| |
|
Hypercoagulable/Thrombophilic States |
|
|
June 2004 Hypercoagulable
states, also referred to as thrombophilias or
prothrombotic disorders, are disorders that
predispose a patient to venous, and sometimes to
arterial, thromboembolism. Identification of
such conditions may indicate a need for
aggressive prophylaxis during high-risk periods,
a need for prolonged treatment after an initial
episode of thromboembolism, avoidance of oral
contraceptives, and investigation of
asymptomatic family members when a familial
disorder is identified. A prothrombotic disorder
should be considered in patients as outlined
below. On the other hand, an indiscriminate
search for underlying hypercoagulable states is
usually unrewarding and may result in false
positive results that inappropriately label
patients as "clotters". Some hypercoagulable
states are associated with late fetal and
recurrent pregnancy loss, intrauterine growth
retardation and probably other obstetric
complications. This guideline will not address
this area further as it is rapidly evolving and
best management in most situations cannot yet be
defined. |
| |
|
Investigators Against Thromboembolism |
|
|
Professional and Patient
Advice, updates on current research/lectures |
| |
|
ONLINE Resource for Hematology Education and
News |
|
|
|
| |
|
Open Directory Project: Thrombosis |
|
|
Directory of links to
thrombosis-related sites |
| |
|
Overview of Thrombophilia |
|
|
Volume 6 Issue 5 Hemaware,
Page 13-16 |
| |
|
Sticky Platelets Boost Blood Clots |
|
|
Science News Online (You May
Need To Subscribe To Science News) |
| |
|
The International Society on Thrombosis and
Haemostasis |
|
|
The ISTH is a non-profit
organization with over 2,800 members from more
than 70 countries. |
| |
|
Thrombophilia |
|
|
Thrombophilia is the
potential to develop dangerous blood clotting in
the veins or arteries. Several types of
conditions have been identified which may lead
to dangerous clots. These conditions may be
present at birth (congenital or inherited) or
may occur as a result of another condition
(acquired). Information provided by the UMHS
Hemophilia and Coagulation Disorders Program,
February 2003 |
| |
|
Thrombophilia |
|
|
Thrombophilia is a disorder
in which the blood clots easily or excessively. |
| |
|
Thrombophilia: What's a Practitioner to Do? |
|
|
Hematology 2001 © 2001 The
American Society of Hematology Discusses the
waxing & waning of aPL, etc. |
| |
|
Thrombophlebitis |
|
|
Mayo Clinic January 31, 2005 |
| |
|
Thrombophlebitis: Blood Clots in Your Legs |
|
|
|
| |
|
Thrombosis Interest Group of Canada |
|
|
"Thrombosis Interest Group of
Canada (T.I.G.C) is dedicated to furthering
education and research in the prevention and
treatment of thrombosis " |
| |
|
Thrombosis Prevention |
|
|
An abnormal blood clot inside
a blood vessel is called thrombosis. Thrombosis
has been described as coagulation occurring in
the wrong place or at the wrong time. The end
result of thrombosis is an obstruction of the
blood flow. Since the leading cause of death in
the Western world is the formation of an
abnormal blood clot inside a blood vessel, it is
important for healthy people to take steps to
prevent thrombosis. For those with risk factors
for developing thrombosis, aggressive actions
must be taken to protect against stroke, heart
attack, kidney failure, pulmonary embolus, etc.
As noted above, thrombi are clots that form in a
blood vessel or in the wrong place: in an
artery, a vein, or in |
| |
|
Thrombosis Research Institute |
|
|
Located in the UK |
| |
|
Trauma as a risk factor for thrombosis in
children: |
|
|
The Turkish Journal of
Pediatrics 2003; 45: 167-169 |
| |
|
Treatment of Blood Clots |
|
|
Circulation; 2002:106
e138-e140. (c) American Heart Association, Inc. |
| |
|
Treatment of Thrombosis |
|
|
|
| |
|
UIUC Hematology Resource Page |
|
|
Excellent information about
the various genetic markers. Includes diagrams. |
| |
|
What are clotting disorders? |
|
|
© 2006 National Hemophilia
Foundation |
| |
|
What does my Blood Test Mean BloodBook Blood
Information For Life |
|
|
|
| |
|
What is “Micro-Clotting”? |
|
|
By: Thomas L. Ortel, MD, PhD
Simply put, micro-clotting, better referred to
as “microvascular thrombosis”’ describes blood
clotting that is occurring in some of the
smallest blood vessels in the body. |
| |
|
What you need to know about Hypercoagulable
States (blood clotting disorders) |
|
|
When you cut or injure
yourself, your body stops the bleeding by
forming a blood clot. Proteins and particles in
your blood, called platelets, stick together to
form the blood clot. The process of forming a
clot is called coagulation. Normal coagulation
is important during an injury, as it helps stop
a cut from bleeding and starts the healing
process. However, the blood shouldn't clot when
it's just moving through the body. If blood
tends to clot too much, it is called
hypercoagulation or a hypercoagulable state
(also called thromboembolic state or
thrombophilia). |
| |
|
Top of Page |
|
|
Thrombosis Information - DVT
|
|
A New Perspective On DVT |
|
|
Deep vein thrombosis (DVT) is
a blood clot in a vein. This condition can
affect men or women of any age, race, or social
status. DVT is a potentially serious condition.
Fortunately, advances in technology have made it
easier and virtually painless to confirm that
you have DVT. |
| |
|
ACUTE DEEP VENOUS THROMBOSIS AND ITS
COMPLICATIONS |
|
|
Mark H. Meissner, MD, and E.
Eugene Strandness, Jr., MD |
| |
|
Anticoagulation for three versus six months in
patients with deep vein thrombosis or pulmonary
embolism, or both: randomised trial |
|
|
BMJ,
doi:10.1136/bmj.39098.583356.55 (published 8
February 2007) Conclusion: For patients in the
UK with deep vein thrombosis or pulmonary
embolism and no known risk factors for
recurrence, there seems to be little, if any,
advantage in increasing the duration of
anticoagulation from three to six months. Any
possible advantage would be small and would need
to be judged against the increased risk of
haemorrhage associated with the longer duration
of treatment with warfarin. |
| |
|
Clots linked to cabin pressure, air |
|
|
Low oxygen in aircraft
investigated as cause of deep vein thrombosis in
passengers' legs |
| |
|
Coalition to Prevent DVT |
|
|
DVT occurs when a blood clot
forms in a deep vein, usually in the lower
limbs. A complication of DVT, pulmonary
embolism, can occur when a fragment of a blood
clot breaks loose from the wall of the vein and
migrates to the lungs, where it blocks a
pulmonary artery or one of its branches. |
| |
|
Deep vein thrombosis |
|
|
Published by BUPA's Health
Information Team June 2003 |
| |
|
Deep Venous Thrombosis |
|
|
Another article by Craig
Freied, MD from emedicine site |
| |
|
Deep venous thrombosis |
|
|
Update Date: 10/28/2003
Updated by: Ezra E. W. Cohen, M.D., Section of
Hematology/Oncology, Department of Medicine, The
University of Chicago, Chicago, IL. Review
provided by VeriMed Healthcare Network. |
| |
|
Deep Venous Thrombosis and Thrombophlebitis |
|
|
Last Updated: March 2, 2005 |
| |
|
Deep Venous Thrombosis, Lower Extremity |
|
|
Another article from
emedicine site, radiological perspective |
| |
|
Diagnosis and treatment of deep-vein thrombosis |
|
|
CMAJ • October 24, 2006; 175
(9). doi:10.1503/cmaj.060366. © 2006 CMA Media
Inc. or its licensors. Deep-vein thrombosis
(DVT) is a common condition that can lead to
complications such as postphlebitic syndrome,
pulmonary embolism and death. The approach to
the diagnosis of DVT has evolved over the years.
Currently an algorithm strategy combining
pretest probability, D-dimer testing and
compression ultrasound imaging allows for safe
and convenient investigation of suspected
lower-extremity thrombosis. Patients with low
pretest probability and a negative D-dimer test
result can have proximal DVT excluded without
the need for diagnostic imaging. The mainstay of
treatment of DVT is anticoagulation therapy,
whereas interventions such as thrombolysis and
placement of inferior vena cava filters are
reserved for special situations. The use of
low-molecular-weight heparin allows for
outpatient management of most patients with DVT.
The duration of anticoagulation therapy depends
on whether the primary event was idiopathic or
secondary to a transient risk factor. More
research is required to optimally define the
factors that predict an increased risk of
recurrent DVT to determine which patients can
benefit from extended anticoagulant therapy. |
| |
|
Does acute infection raise the risk of venous
thromboembolism? |
|
|
Smeeth L, Cook C, Thomas S,
Hall AJ, Hubbard R, Vallance P. Risk of deep
vein thrombosis and pulmonary embolism after
acute infection in a community setting. Lancet.
APRIL1–7 2006;367:1075-1079. Answer: Yes. Acute
urinary or respiratory tract infection is linked
to a substantial but reversible increase in the
risk of venous thromboembolism. The risk
increased significantly in the first 2 weeks
after acute infection and gradually returned to
baseline over 12 months. |
| |
|
Duration of Oral Anticoagulant Therapy for
Venous Thromboembolism |
|
|
|
| |
|
DVT : What is it? |
|
|
|
| |
|
DVT and Pulmonary Embolism: Part I. Diagnosis |
|
|
Am Fam Physician
2004;69:2829-36. Copyright© 2004 American
Academy of Family Physicians. DINO W. RAMZI,
M.D., C.M., and KENNETH V. LEEPER, M.D., Emory
University School of Medicine, Atlanta, Georgia |
| |
|
DVT diagnosis failure criticised |
|
|
Hospitals are failing to
properly diagnose patients with potentially
fatal deep vein thrombosis, according to a
public service watchdog. Published: 2006/05/31
18:28:41 GMT © BBC MMVI |
| |
|
DVT victims denied right to sue |
|
|
Victims of deep vein
thrombosis have lost their appeal for the right
to claim compensation from airlines. Last
Updated: Thursday, 8 December 2005, 13:02 GMT |
| |
|
DVT.net |
|
|
|
| |
|
Exclusion of deep venous thrombosis with D-dimer
testing--comparison of 13 D-dimer methods in 99
outpatients suspected of deep venous thrombosis
using venography as reference standard. |
|
|
Thromb Haemost. 2000
Feb;83(2):191-8. Comment in: Thromb Haemost.
2000 Dec;84(6):1134-5. Thromb Haemost. 2000
Feb;83(2):180-1. |
| |
|
Flight-related Deep Vein Thrombosis (DVT)
-Economy Class Syndrome |
|
|
(posted 7/1/01) |
| |
|
How I treat venous thrombosis in children |
|
|
Blood, 1 January 2006, Vol.
107, No. 1, pp. 21-29. |
| |
|
INATE - the thrombosis (DVT and PE) resource for
patients and professionals |
|
|
|
| |
|
Initial Treatment of Venous Thromboembolism |
|
|
The objectives of treatment
for patients with venous thromboembolism (VTE)
(deep venous thrombosis and/or pulmonary
embolism) are 1) to prevent death from pulmonary
embolism, 2) to relieve symptoms and prevent
extension of deep venous thrombosis, 3) to
prevent recurrent VTE, and 4) to prevent the
post thrombotic syndrome. The anticoagulant
drugs heparin, low molecular weight heparin
(LMWH) and warfarin constitute the mainstay of
treatment of VTE. In selected cases the use of
thrombolytic agents and/or the insertion of an
inferior vena cava filter may be indicated. The
use of graduated compression stockings following
an episode of deep venous thrombosis has been
shown to decrease the incidence of the post
thrombotic syndrome. For further information on
the use of heparin and warfarin, please refer to
the guidelines located elsewhere on the TIG web
site. |
| |
|
Is Heparin or LMWH Safer and More Efficacious
for Initial Treatment of VTE? Is It
Cost-Effective or Cost-Saving To Use LMWH rather
than Unfractionated Heparin for the Initial
Treatment of VTE? |
|
|
Ann Fam Med. 2007;5(1):74-80.
©2007 Annals of Family Medicine, Inc. |
| |
|
Laboratory Markers in the Diagnosis of Venous
Thromboembolism |
|
|
(Circulation. 2004;109:I-4 –
I-8.) © 2004 American Heart Association, Inc. |
| |
|
Lower Extremity Venous Anatomy and the use of
Ultrasound for Detecting and Diagnosing Thrombus
By: Erika Godfrey |
|
|
Quick lesson of veins in the
legs as well as information on "decoding" the
lingo of ultrasound diagnosis |
| |
|
Patient information: Venous thrombosis |
|
|
Gregory YH Lip, MD, FRCPE,
FESC, FACC The University of Birmingham Graham F
Pineo, MD Foothills Hospital Kenneth A Bauer, MD
Harvard Medical School |
| |
|
Post Graduate Medicine DVT |
|
|
Here is a list of terms
useful to the new DVT patient |
| |
|
Prevention of Deep Vein Thrombosis and Pulmonary
Embolism - Cardiology Patient Page |
|
|
(Circulation.
2004;110:e445-e447.) © 2004 American Heart
Association, Inc. |
| |
|
Prevention Of Perioperative Deep Venous |
|
|
B. Todd Sitzman, M.D., M.P.H.
B. Todd Sitzman, M.D., M.P.H. is with the
Department of Anesthesiology and Pain
Management, Mayo Clinic Jacksonville.
Jacksonville Medicine / December, 1998 |
| |
|
Report Suggests a Connection between Blood Type
and DVT Risk |
|
|
Source: Obesity, Fitness &
Wellness Week, September 3, 2005 |
| |
|
Reporting Standards for Endovascular Treatment
of Lower Extremity Deep Vein Thrombosis |
|
|
Vedantham et al. 17 (3) 417 |
| |
|
Thrombophlebitis |
|
|
Medline |
| |
|
What Is Deep Vein Thrombosis? |
|
|
Deep vein thrombosis
(throm-BO-sis) is a blood clot that forms in a
vein deep in the body. Most deep vein clots
occur in the lower leg or thigh. They also can
occur in other parts of the body. January 2006 |
| |
|
Top of Page |
|
|
Thrombosis Information - Other
|
|
A Clinical Perspective of Venous Thromboembolism |
|
|
Arteriosclerosis, Thrombosis,
and Vascular Biology. 2008;28:373. © 2008
American Heart Association, Inc. |
| |
|
Ask the Lab - D-dimer |
|
|
1. “Can the D-dimer be used
to diagnose venous thrombosis?” 2. “I know that
the D-dimer has many false-positives, but are
there also false-negatives?” |
| |
|
Birth control options in thrombophilia |
|
|
While progestin-only
contraceptives do not increase the risk of
thrombosis in the general population, it is not
known whether they may increase the risk for
thrombosis in people who (a) have had a previous
clot or (b) have factor V Leiden or another
thrombophilia. In the absence of data I think it
is fair to conclude that one can not rule out a
small increased risk of thrombosis with
progestin-only contraceptives. The concern about
a potential thrombophilic risk of progestin-only
contraceptives stems from the fact that
progestins used at higher doses for other
purposes than contraception (dysfunctional
uterine bleeding, amenorrhea) may be associated
with an increased risk of thrombosis. This is a
scientific field that is evolving and hopefully
at some point in the future we will have data as
to whether progestin-only contraceptives
increase the risk for thrombosis in
thrombosis-prone individuals or not.
Progestin-only contraceptives are: Oral pills
Micronor®, Ovrette®, NOR-QD®. Depo-Provera (=
depot medroxy-progesterone) Mircette® IUD |
| |
|
Blood Chemistry Definitions |
|
|
|
| |
|
BLOOD CLOTS AND PICC (PERIPHERALLY INSERTED
CENTRAL CATHETER) LINES |
|
|
Last update August 29, 2004 |
| |
|
Blood or organ donation and thrombophilia |
|
|
Last Updated: 9/13/05 |
| |
|
Can causes of false-normal D-dimer test [SimpliRED]
results be identified? |
|
|
Thromb Res.
2003;111(3):155-8. |
| |
|
Clotting Disorders Presentation |
|
|
This presentation on
inherited and acquired blood clotting disorders
was presented in Columbus, OH in May, 2006 at
the patient education seminar presented by the
National Alliance for Thrombosis and
Thrombophilia. The presenter is Stephan Moll,
M.D. from the University of North Carolina,
Chapel Hill. |
| |
|
Cost Implications of Using Unfractionated
Heparin or Enoxaparin in Medical Patients at
Risk for Venous Thromboembolic Events |
|
|
322 P&T® • June 2006 • Vol.
31 No. 6. Conclusion. Enoxaparin was associated
with lower total inpatient costs of care than
UFH for preventing VTE in hospitalized at-risk
patients. |
| |
|
Cost Implications of Using Unfractionated
Heparin or Enoxaparin in Medical Patients at
Risk for Venous Thromboembolic Events |
|
|
|
| |
|
D-dimer |
|
|
Also known as: Fragment D-dimer,
Fibrin degradation fragment This page was last
modified on December 29, 2004. |
| |
|
Derivation of a Clinical Decision Rule to
Decrease the Rate of False-positive D-dimer
Assays in Emergency Department Patients
Evaluated for Pulmonary Embolism |
|
|
Acad Emerg Med Volume 12,
Number 5_suppl_1 42, © 2005 Society for Academic
Emergency Medicine Academic Emergency Medicine
Volume 12, Number 5 suppl 1 42, © 2005 Society
for Academic Emergency Medicine Michael S.
Runyon, William B. Webb, Alan E. Jones and
Jeffrey A. Kline |
| |
|
Disseminated Intravascular Coagulation |
|
|
Disseminated intravascular
coagulation (DIC) is a complex systemic
thrombohemorrhagic disorder involving the
generation of intravascular fibrin and the
consumption of procoagulants and platelets. The
subcommittee on DIC of the International Society
on Thrombosis and Hemostasis has suggested the
following definition for DIC: ”An acquired
syndrome characterized by the intravascular
activation of coagulation with loss of
localization arising from different causes. It
can originate from and cause damage to the
microvasculature, which if sufficiently severe,
can produce organ dysfunction”. |
| |
|
eMedicine - Cerebral Venous Thrombosis Article
by W Alvin McElveen, MD |
|
|
Thrombosis of the venous
channels in the brain is an uncommon cause of
cerebral infarction relative to arterial disease
but is an important consideration because of its
potential morbidity. Venous thrombosis may occur
with headache and cranial nerve palsies. Newer
imaging procedures have led to easier
recognition of venous sinus thrombosis, offering
the opportunity for early therapeutic measures.
Venous thrombosis also may be associated with
other medical complications that require
therapeutic intervention. Last Updated: October
3, 2006 |
| |
|
eMedicine - Mesenteric Venous Thrombosis :
Article by Deron J Tessier |
|
|
Mesenteric venous thrombosis
(also known as visceral venous thrombosis) is a
rare but lethal form of mesenteric ischemia.
Antonio Hodgson first described mesenteric
ischemia in the latter part of the 15th century.
In 1895, Elliot first described mesenteric
venous thrombosis as a cause of mesenteric
ischemia. By the turn of the 19th century, many
review articles and texts were describing the
recent advances in the characterization and
treatment of mesenteric ischemia, particularly
venous thrombosis. In 1935, Warren and Eberhard
reported that intestinal infarction resulted
from ischemia due to venous thrombosis, and they
reported a mortality rate of 34% in patients
with venous thrombosis after resection.
Unfortunately, despite improvements in therapy,
this mortality rate still holds. |
| |
|
False-Positive D-Dimer Result in a Patient With
Castleman Disease |
|
|
Archives of Pathology &
Laboratory Medicine, Mar 2004 by Mugler,
Kimberly, Lefkowitz, Jerry B |
| |
