Simple scoring system for early management of heparin-induced thrombocytopenia.

This study was performed to develop a simple scoring system to aid in the early clinical management of patients suspected of heparin-induced thrombocytopenia (HIT) with regard to decisions for continued heparin therapy. The system was designed to arrive at low (0) or possible (1) probability scores without knowledge of laboratory test results (except platelet counts) to avoid delays. As the safest clinical approach is to discontinue heparin, intermediate and high scores were combined.

Wine, beer, and spirits metabolism.

Comprehensive therapists regularly encounter patients consuming alcoholic beverages. It remains important that they understand how the body deals with its consumption, whether temperate and intemperate.

Alcohol consumption: benefit versus peril.

Like medication, alcohol has benefits in appropriate small doses and has perils in greater doses. Comprehensive therapists need to understand both!

Human sexual intercourse.

The comprehensive therapist needs to view human sexual intercourse comprehensively to avoid its hazards and to promote its benefits for all patients.

Rivaroxaban--an oral, direct Factor Xa inhibitor--has potential for the management of patients with heparin-induced thrombocytopenia.

Rivaroxaban is an oral, direct activated Factor Xa (FXa) inhibitor in advanced clinical development for the prevention and treatment of thromboembolic disorders. Currently available anticoagulants include unfractionated heparin (UFH) and low molecular weight heparins (LMWHs); however, their use can be restricted by heparin-induced thrombocytopenia (HIT). HIT is usually caused by the production of antibodies to a complex of heparin and platelet factor-4 (PF4).

Laboratory evaluation of the antiphospholipid syndrome.

Antiphospholipid syndrome (APLS) is among the most common acquired blood protein defects that have been identified as leading to thrombosis. This article describes the laboratory diagnosis of APLS, including the detection of lupus anticoagulants, anticardiolipin antibodies, and subtypes of antiphospholipid antibodies.

Pulmonary arterial hypertension.

Better recognition of primary pulmonary hypertension can produce better treatment by comprehensive therapists.

The classical vs nonclassical NSAIDs: can the reduction in pain overcome the thrombotic risk?

The advent of cyclooxygenase-2 inhibitors has been both a blessing and a curse for pain management. An in-depth understanding of the biological molecules in the arachidonic acid metabolism may alleviate pain without risk.

Pain, analgesics, and the cardiovascular system.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most used medications in the world. Ordinarily considered to be safe and effective when used according to labeling instructions, their safety for patients with cardiovascular disease is now being reassessed.

Thromboembolism in cancer patients: pathogenesis and treatment.

In this review we summarize the causes of cancer related thrombosis as well as modern treatment approaches. Malignancy as a risk factor for thromboembolism is becoming increasingly recognized by clinicians caring for these patients. The probability of thrombosis occurring in an individual patient is dependent on several factors, including accompanying medical problems, the type of cancer, the clinical stage, performance status, and the treatment modalities employed.

Sudden unexpected death.

Sudden unexpected death is a major public health problem. Many cases could be prevented if they were anticipated through means of a better awareness among the medical community, new therapies based on early genetic screening, or corrected by countershock.

Antithrombotic agents in the treatment of severe sepsis.

Sepsis, a systemic inflammatory syndrome, is a response to infection and when associated with multiple organ dysfunction is termed severe sepsis. It remains a leading cause of mortality in the critically ill. The response to the invading microorganisms may be considered as a balance between a pro-inflammatory and an anti-inflammatory reaction.

A woman's body and her vascular system are unique. How should we care for them?

Women must now gain the phenomenal care justified by new biologic evidence and a comprehensive understanding of fundamental differences from men-that go well beyond secondary sexual characteristics.

Antiplatelet agents: current drugs and future trends.

Antiplatelet drugs in clinical use are discussed in terms of their mechanisms of action and the relevancy of that to the physiology of platelets and the pathophysiology of arterial thrombosis. Current clinical usage is outlined in detail for each drug. Experimental antiplatelet drugs also are discussed.