Hematology

Download Consultative Hemostasis and Thrombosis by Craig S. Kitchens, MD, MACP, Barbara M. Alving, MD, MACP, PDF

By Craig S. Kitchens, MD, MACP, Barbara M. Alving, MD, MACP, and Craig M. Kessler, MD, MACP (Auth.)

Successfully and successfully diagnose and deal with brand new complete variety of clotting and bleeding problems utilizing scientific case reports that reveal real-world difficulties and suggestions! for every situation tested, you are going to overview concise descriptions of its linked indicators, besides laboratory findings, prognosis, differential prognosis, and remedy - all of the medical suggestions you would like - at your fingertips. it is the excellent real-life reference instrument for busy physicians!

  • A reader-friendly layout, coupled with approximately 385 illustrations and at-a-glance tables - many new to this version - equip you to speedy find the counsel you need.
  • Abundant laboratory protocols assist you opt for and interpret lab assessments extra easily.
  • A whole part on women's overall healthiness concerns is helping you remain present during this evolving region.
  • A new bankruptcy at the effect of natural medications examines their impression on hemostasis and their interplay with different drugs.
  • New insurance of hemostatic concerns in traumatology, sepsis, interventional radiology, pulmonology, and cardiology permits you to grasp the most recent advances.

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Additional resources for Consultative Hemostasis and Thrombosis

Example text

26 Because of the vagaries associated with BT techniques, standardized, automated techniques have been designed to examine and simulate the platelet contribution to primary hemostasis in a more specific manner. The Platelet Function Analyzer (PFA)-100 (Dade-Behring, Marburg, Germany) has been developed as an automated, rapid technique designed to assess platelet adhesion and aggregation. In many hospitals, it has replaced BT as the predominant assessment tool used to screen patients for their bleeding potential.

These assays are more sensitive than clotting time– based assays and are not interfered with by LAs. Because of their increased cost per assay, they have not yet pervaded most of the coagulation laboratories in the United States. Shortened PTTs and PTs have little clinical significance and probably reflect elevated FVIII activity levels or other clotting factors activated as a result of DIC or the presence of pregnancy (and its complications), use of estrogen hormones, active or occult thrombosis, carcinoma, or Tests for Lupus Anticoagulants (LA) When mixing studies indicate the persistence of a prolonged PTT, the presence of an LA should be confirmed with assays that show that the antibody is directed against the phospholipid component of coagulation.

Commercially available agents most often used to activate the clotting process in PT consist of standardized mixtures of tissue factor/thromboplastin (extracted from rabbit brain) and calcium chloride; however, preparations of recombinant human tissue factor mixed with synthetic phospholipids are becoming more popular because they are free of the contaminating coagulation factor proteins present in tissue factor extracts. This increases the sensitivity of the PT assay for factor deficiencies. 37 Because numerous tissue factor/thromboplastin reagents possess various procoagulant properties, PT results may vary widely from one laboratory to another—even for the same plasma specimen.

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