Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Child protection is a priority, and the medical community has a responsibility to detect cases of abuse and to intervene using the appropriate measures. Bruises are the most common manifestation of physical abuse, although their interpretation can be extremely challenging for paediatricians as the evidence base is limited. As a history of abuse is a strong risk factor for further non-accidental injury, a correct diagnosis is vital. ⋯ The paediatrician must also consider the combined probabilities of individual bruises being due to abuse. Our scoring system, which uses a Bayesian approach to evaluate these probabilities and assess bruising patterns, is a potentially useful tool for discriminating between abused and non-abused children. We recommend that paediatricians and haematologists should work together to reach a diagnostic consensus that is acceptable in both the clinic and a court of law.
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Blood Coagul. Fibrinolysis · May 2004
Review Randomized Controlled Trial Clinical TrialRecombinant activated factor VII in cardiac surgery.
Adult cardiac surgery has an incidence of 1-1.25 million procedures per year. Overall costs are in the range of 50 billion US dollars per year and are increasing. Included in these costs is an increasing burden from the use of blood and blood products. ⋯ The primary endpoints of the study are use of blood and blood products. Secondary endpoints are blood loss, length of stay in the intensive care unit and in the hospital, and survival. This study will give us further information on the potential efficacy and safety of rFVIIa in cardiac surgery.
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Blood Coagul. Fibrinolysis · May 2004
ReviewRole of the tissue factor pathway in the pathogenesis and management of multiple organ failure.
Sepsis is caused by a dysregulated immune response to infection and, without intervention, can lead to septic shock and multiple organ failure. A leading cause of morbidity and mortality in intensive care units worldwide, severe sepsis is also associated with a considerable cost burden that places significant strain on global healthcare budgets. ⋯ This paper will examine the pathophysiology of sepsis and multiple organ dysfunction before reviewing trials recently undertaken to investigate three potential anticoagulant therapies: antithrombin III, activated protein C, and tissue factor pathway inhibitor. Finally, other recent developments in the care of sepsis patients will be briefly examined.