Bailliere's clinical haematology最新文献_第3页

7 Thrombolytic therapy for venous thrombosis and pulmonary embolism 静脉血栓和肺栓塞的溶栓治疗

Bailliere's clinical haematology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3536(98)80088-7

MB BS, FRACP, FRCPA, FRCP(C) A.S. Gallus (Haematologist and Director)

{"title":"7 Thrombolytic therapy for venous thrombosis and pulmonary embolism","authors":"MB BS, FRACP, FRCPA, FRCP(C) A.S. Gallus (Haematologist and Director)","doi":"10.1016/S0950-3536(98)80088-7","DOIUrl":"10.1016/S0950-3536(98)80088-7","url":null,"abstract":"<div><p>Streptokinase, urokinase, tissue plasminogen activator and similar drugs can all cause lysis of venous thrombi and pulmonary emboli, but there is small evidence that accelerated lysis achieves a significantly better clinical outcome, on average, in the shorter or longer term, than heparin alone. Thrombolytic therapy for deep leg vein thrombosis aims to restore flow and to preserve venous valves, and so to prevent chronic post-phlebitic disability, but no trial has convincingly demonstrated that the last can be achieved in more than a few patients. Only a small minority of people with extensive proximal thrombosis develop disabling post-phlebitic venous insufficiency, and there are no good clinical predictors of this outcome. As a result, any widespread use of thrombolytics would bring an immediate risk of major bleeding to many people who will never be destined to develop a clinically important problem. Thrombolytic therapy after venous thrombosis should be avoided except, perhaps, in a few carefully selected patients with severe obstruction. The case for using thrombolytics after recent pulmonary embolism is strongest in the limited number of patients with ongoing hypoxia, respiratory distress, pulmonary hypertension and right heart failure, because thrombolytic therapy often achieves an impressive and almost immediate clinical benefit in this clinical setting. Whether early relief from pulmonary artery obstruction translates into longer-term advantage over heparin remains uncertain, however, because no comparative trial has ever shown these drugs to reduce mortality after pulmonary embolism. In all cases, both the physician and the patient must balance the certainty of an immediate bleeding risk against the uncertainty of a better than marginal real benefit.</p></div>","PeriodicalId":77029,"journal":{"name":"Bailliere's clinical haematology","volume":"11 3","pages":"Pages 663-673"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3536(98)80088-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21200580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

4 Prevention of venous thromboembolism in general surgery 4普外科静脉血栓栓塞的预防

Bailliere's clinical haematology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3536(98)80085-1

FRCS, FRCSE Vijay Vir Kakkar (Director), MD, CCST Ferruccio de Lorenzo (Lecturer)

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引用次数: 16

9 The fetal and neonatal consequences of maternal alloimmune thrombocytopenia 母体同种免疫性血小板减少症对胎儿和新生儿的影响

Bailliere's clinical haematology Pub Date : 1998-06-01 DOI: 10.1016/S0950-3536(98)80057-7

MD James Bussel (Associate Professor), MD Cecile Kaplan (Director of Platelet-Leukocyte Immunology)

引用次数: 39

16 Deficiency of von Willebrand factor-cleaving protease in familial and acquired thrombotic thrombocytopenic purpura 家族性和获得性血栓性血小板减少性紫癜中血管性血友病因子切割蛋白酶缺乏

Bailliere's clinical haematology Pub Date : 1998-06-01 DOI: 10.1016/S0950-3536(98)80064-4

PhD Miha Furlan (Associate Professor), MD Bernhard Lämmle (Professor and Director)

引用次数: 44

Index 指数

Bailliere's clinical haematology Pub Date : 1998-06-01 DOI: 10.1016/S0950-3536(98)80065-6

引用次数: 0

11 Thrombopoietin: its role in platelet disorders and as a new drug in clinical medicine 11血小板生成素:在血小板紊乱中的作用及作为临床新药的应用

Bailliere's clinical haematology Pub Date : 1998-06-01 DOI: 10.1016/S0950-3536(98)80059-0

MD, PhD Albert E.G. Kr von dem Borne (Professor of Clinical Hematology and Immunohematology) , Claudia Folman (Doctorate Student) , Gabor E. Linthorst (Medical Student), MD Leendert Porcelijn (Head of the Laboratory of Platelet and Leukocyte Serology), Sonja van den Oudenrijn (Doctorate Student), MD, PhD Ellen van der Schoot (Head of the Immunocytology Laboratory), MD, PhD Masja de Haas (Senior Scientist)

{"title":"11 Thrombopoietin: its role in platelet disorders and as a new drug in clinical medicine","authors":"MD, PhD Albert E.G. Kr von dem Borne (Professor of Clinical Hematology and Immunohematology) , Claudia Folman (Doctorate Student) , Gabor E. Linthorst (Medical Student), MD Leendert Porcelijn (Head of the Laboratory of Platelet and Leukocyte Serology), Sonja van den Oudenrijn (Doctorate Student), MD, PhD Ellen van der Schoot (Head of the Immunocytology Laboratory), MD, PhD Masja de Haas (Senior Scientist)","doi":"10.1016/S0950-3536(98)80059-0","DOIUrl":"10.1016/S0950-3536(98)80059-0","url":null,"abstract":"<div><p>The cloning and characterization of thrombopoietin and its receptor Mpl in the past few years has been a major advance in haematology. It opens new ways of studying congenital and acquired platelet disorders, leading to new insights in the pathogenesis and treatment of this group of diseases.</p><p>The Tpo level of the blood appears to be a useful marker for the differentiation between thrombocytopenia due to peripheral destruction and that due to thrombocytopoietic failure. No simple clinical parameter exist for this important differential diagnostic problem.</p><p>When recombinant thrombopoietin becomes available for therapy it will rapidly become the drug of choice for many of our patients. However, because of all the legal and commercial issues at stake it is expected that it will still take a few more years before general availability is realized. Short peptides with Tpo activity (<span>Cwirla et al, 1997</span>; <span>Kimura et al, 1997</span>), which can be synthesized chemically, may form a more easily obtainable alternative.</p></div>","PeriodicalId":77029,"journal":{"name":"Bailliere's clinical haematology","volume":"11 2","pages":"Pages 427-445"},"PeriodicalIF":0.0,"publicationDate":"1998-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3536(98)80059-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20969447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

13 Heparin-induced thrombocytopenia: pathophysiology and clinical concerns 肝素诱导的血小板减少症:病理生理学和临床关注

Bailliere's clinical haematology Pub Date : 1998-06-01 DOI: 10.1016/S0950-3536(98)80061-9

MD Andreas Greinacher (Professor)

引用次数: 6

1 Acquired haemophilia 1获得性血友病

Bailliere's clinical haematology Pub Date : 1998-06-01 DOI: 10.1016/S0950-3536(98)80049-8

MD, FRCP, FRCPath Charles R.M. Hay (Director)

引用次数: 130

3 Acquired von Willebrand disease 3获得性血管性血友病

Bailliere's clinical haematology Pub Date : 1998-06-01 DOI: 10.1016/S0950-3536(98)80051-6

MD, PhD Perry J.J. van Genderen (Resident Internal Medicine and Haematology), MD, PhD Jan J. Michiels (Internist/Haematologist)

{"title":"3 Acquired von Willebrand disease","authors":"MD, PhD Perry J.J. van Genderen (Resident Internal Medicine and Haematology), MD, PhD Jan J. Michiels (Internist/Haematologist)","doi":"10.1016/S0950-3536(98)80051-6","DOIUrl":"10.1016/S0950-3536(98)80051-6","url":null,"abstract":"<div><p>Acquired von Willebrand disease (AvWD) is an acquired bleeding disorder which may suddenly become manifest in individuals, usually in the absence of a personal or family history of bleedings and frequently in association with monoclonal gammopathies, lymphoproliferative, myeloproliferative and autoimmune disorders. In a minority of the cases AvWD may develop in association with drugs or solid tumours. Pathogenetic mechanisms involve autoantibodies directed against von Willebrand factor (vWF) resulting in a rapid clearance of vWF from the circulation and/or inactivation of plasma vWF; absorption or adsorption of plasma vWF to malignant cells; drug-induced or cell-mediated proteolysis of plasma vWF; acquired decrease in synthesis of vWF and/or release of vWF from storage sites; or precipitation of plasma vWF. Treatment options include—whenever possible—treatment of the underlying disorder or symptomatic treatment aimed at replacing the loss of vWF by either infusion of vWF-rich concentrates or administration of desmopressin (DDAVP). In selected cases with anti-vWF antibodies, administration of high-dose intravenous gammaglobulin, plasma exchange or extracorporeal immunoadsorption may be successful.</p></div>","PeriodicalId":77029,"journal":{"name":"Bailliere's clinical haematology","volume":"11 2","pages":"Pages 319-330"},"PeriodicalIF":0.0,"publicationDate":"1998-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3536(98)80051-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20970131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 34

8 Acute autoimmune thrombocytopenia 8急性自身免疫性血小板减少症

Bailliere's clinical haematology Pub Date : 1998-06-01 DOI: 10.1016/S0950-3536(98)80056-5

Dr. med. Anton Heinz Sutor (Professor, Section Haematology and Haemostaseology), Dr. med. G. Gaedicke (Professor, chairman of Pediatrics)

{"title":"8 Acute autoimmune thrombocytopenia","authors":"Dr. med. Anton Heinz Sutor (Professor, Section Haematology and Haemostaseology), Dr. med. G. Gaedicke (Professor, chairman of Pediatrics)","doi":"10.1016/S0950-3536(98)80056-5","DOIUrl":"10.1016/S0950-3536(98)80056-5","url":null,"abstract":"<div><p>Childhood acute autoimmune thrombocytopenia is defined as a bleeding disorder in otherwise healthy children caused by transient destruction of platelets. It is benign, presenting mostly with skin purpura and minor bleeds. The diagnosis requires information about previous infections or immunizations, a physical examination looking for signs or symptoms for other causes of thrombocytopenia and a complete blood count with examination of the peripheral blood smear focusing on the number and morphology of platelets. Bone marrow examination is indicated only when in doubt and should be considered if prednisone therapy is planned. A threshold platelet count dividing high- and low-risk groups in immune thrombocytopenia (ITP) is not known because of problems with platelet counting in thrombocytopenia and the lack of clinical data. Immunoglobulins or glucocorticoids increase the platelet count, probably by blockage of the phagocytic monocyte-macrophage system. However, it is unclear whether this increase influences bleeding or mortality or whether the disadvantages of these medications might outweigh their benefits.</p></div>","PeriodicalId":77029,"journal":{"name":"Bailliere's clinical haematology","volume":"11 2","pages":"Pages 381-389"},"PeriodicalIF":0.0,"publicationDate":"1998-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3536(98)80056-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20969444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2