Caval filter placement for pulmonary embolism in a patient with a deep vein thrombosis and primary intracerebral haemorrhage.

Treatment of deep vein thrombosis and pulmonary embolic disease when full anticoagulation is absolutely or relatively contraindicated is difficult. We report on a case where the chosen treatment proved unsuccessful. Our patient had a primary intracerebral haemorrhage, complicated by a proximal deep vein thrombosis and despite placement of a vena caval filter, had multiple pulmonary emboli and died.

Age- and sex-related bias in the management of heart disease in a district general hospital.

Objective: To investigate the clinical management of heart disease and determine whether there was age- and sex-related bias in the use of investigations and interventions.

Design: Retrospective analysis of individual patient records against criteria of appropriateness based on published guidelines, clinical practice and literature relevant to the 1996-7 study period.

Setting: A single, district general hospital in London, serving a population of 185,000 people.