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Your search term(s) "Bleeding Disorders" returned 36 results.

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Bleeding Disorder Basics. Pediatric Nursing. 30(5): 402-405, 428-429. September-October 2005.

This article helps pediatric nurses understand the basics of bleeding disorders in children. The most common genetic bleeding disorder is von Willebrand disease, a genetic disorder characterized by easy bruising and frequent and prolonged bleeding from mucous membranes, such as nosebleeds, menorrhagia (excessive menstrual bleeding), or bleeding after oral surgery. Other disorders discussed include the hemophilias, and platelet or fibrinogen; the latter are extremely rare. The author discusses the products and treatments used for bleeding episodes, the physiology of the clotting process, and the management of children with bleeding disorders. Five patient management strategies are advocated: prompt and adequate treatment, testing for bloodborne viruses, immunizations, physical activity, and regular visits to a hemophilia treatment center. The author concludes with a section describing current research initiatives and resources for readers wishing to obtain additional information. 5 figures. 2 tables. 25 references.

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Diagnosis and Management of Mild Bleeding Disorders. IN: Hematology 2005. Washington, DC: American Society of Hematology. 2005. pp. 423-428.

This article reviews the diagnosis and management of mild bleeding disorders, which are a common reason for a referral to a hematologist. The author notes that some bleeding symptoms are quite common in the general population, and there is great variety in the symptoms among individuals with defined bleeding problems. Risks for many bleeding disorders are unknown. The author reviews symptoms and problems that can be considered suspicious of a mild form of bleeding disorder and the diagnostic investigations that may be used to further investigate these disorders. The author presents a stepwise approach for the diagnostic evaluation of common and rare coagulation and fibrinolytic defects and adequate assessments of potential von Willebrand factor and platelet problems. The author includes a section on diagnostic difficulties, including the common failure to establish a diagnosis with standard laboratory testing. Patient education approaches are also reviewed. 40 references.

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Management of Bleeding Disorders in Children. IN: Hematology 2005. Washington, DC: American Society of Hematology. 2005. pp. 416-422.

This article, from a special issue on the clinical management of bleeding disorders, considers the management of bleeding disorders in children. The author emphasizes that the diagnosis and management of congenital and acquired bleeding disorders in children requires an understanding of the unique characteristics of pediatric hemostasis as well as the natural course of bleeding disorders in children, which may differ from the course observed in adults. The author focuses on three bleeding disorders: neonatal alloimmune thrombocytopenia (NAIT), hemophilia, and immune-mediated thrombocytopenia purpura (ITP). The unique physiology of transplacental transfer of maternally derived anti-platelet antibodies can result in NAIT, which is a significant cause of morbidity and mortality from bleeding in affected infants. For patients with hemophilia, treatment strategies have changed from on-demand therapy to primary or secondary prevention, which results in the delay of onset or even a complete avoidance of hemophilic arthropathy. Regarding the management of ITP of childhood, although several effective management strategies have been developed, the side effects associated with these treatments can require the clinician to also consider the option of carefully observing, but not treating, children with ITP. 1 table. 43 references.

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New Perspectives in Hemophilia Treatment. IN: Hematology 2005. Washington, DC: American Society of Hematology. 2005. pp. 429-435.

This article explores new perspectives in hemophilia treatment, focusing on the variety of factor concentrates that are available for replacement therapy. The author notes that the choice of replacement product reflects both safety issues of pathogen transmission or inhibitor development and personal preferences of the patient and physician. In general, available products are viral pathogen-free, although there is debate about the risk of transmission of parvovirus B19 and prion pathogens. Because of this very small risk, recombinant factor is the treatment of choice in previously untreated patients. The management of hemophilia patients with inhibitors is an ongoing challenge. Immune tolerance induction using a desensitization technique is successful in up to 90 percent of patients with alloantibodies against factor VIII, with greatest success seen in patients with low titer inhibitors who are treated soon after detection of an alloantibody and in whom treatment includes administration of immunosuppression along with repeated infusions of high titer concentrates. Such therapy is less successful in patients with factor IX alloantibodies. A final section discusses the management of nonhemophiliac patients with acquired inhibitors. These patients have a mortality rate that approaches 25 percent because of the association of acquired inhibitors with severe bleeding complications, occurrence in a largely elderly population, and the frequent presence of an underlying, often serious, primary medical condition. Treatment consists of immunosuppression with steroids, chemotherapy, or intravenous immunoglobulin. 2 figures. 2 tables. 14 references.

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Basic Science, Diagnosis And Clinical Management of Von Willebrand Disease. Montreal, Quebec: World Federation of Hemophilia. 2004. 12 p.

This monograph offers an overview of the basic science, diagnosis, and clinical management of von Willebrand disease (VWD), an inherited bleeding disorder that is distinct from hemophilia. Topics include an historical perspective of VWD, the VWD factor gene and factor protein, biological functions of von Willebrand factor, clinical features, epidemiology of VWD, diagnostic approaches, family history, the classification of VWD, VWD during pregnancy, and the prevention and treatment of bleeding patients with VWD, including the use of desmopressin and factor concentrates. The diagnosis of VWD requires three components: personal history of excessive mucocutaneous bleeding, a family history of excessive bleeding, and a laboratory evaluation that is consistent with a quantitative or qualitative defect in von Willebrand factor. Type 1 VWD is the most common form of the disease. Adjunctive therapies such as antifibrinolytic agents and the application of topical hemostatic preparations are used with significant benefit in VWD; in women with menorrhagia, the administration of estrogens often results in significant clinical benefit. 6 figures. 23 references.

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Acute Bleeding from Diverticulosis and Ischemic Colitis. In: Chung, P. and Kim, K.E. Acute Gastrointestinal Bleeding: Diagnosis and Treatment. Totowa, NJ: Humana Press. 2003. p. 163-174.

Lower gastrointestinal (GI) bleeding is a common medical problem in the United States. Two common causes of such bleeding are diverticulosis and ischemic colitis. This chapter reviews the pathogenesis, diagnosis, and management of bleeding associated with these two conditions. The chapter is from a textbook in which leading experts in the fields of gastroenterology, surgery, and radiology comprehensively review the pathophysiology, diagnosis, management, and treatment of acute bleeding disorders of the GI tract. The authors of this chapter note that acute diverticular bleeding is the most common cause of lower GI bleeding. Most patients are otherwise asymptomatic at presentation, and bleeding ceases spontaneously 70 to 80 percent of the time. Ischemic colitis is the most common form of intestinal ischemic injury, most often occurring in the left side of the colon. Colonoscopy is the diagnostic procedure of choice since it allows direct visualization of the mucosa and tissue sampling. Management is usually merely supportive, consisting of bowel rest and intravenous fluid and antibiotics, with most patients recovering in 24 to 48 hours. 2 figures. 39 references.

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Acute Gastrointestinal Bleeding: Diagnosis and Treatment. Totowa, NJ: Humana Press. 2003. 288 p.

Acute gastrointestinal (GI) bleeding accounts for over 300,000 hospitalizations per year and has high morbidity and mortality in those who go undiagnosed. In this textbook, leading experts in the fields of gastroenterology, surgery, and radiology comprehensively review the pathophysiology, diagnosis, management, and treatment of acute bleeding disorders of the GI tract. The authors categorize acute bleeding into upper and lower GI tract sources and provide a differential diagnosis for each disease, evidence-based algorithms for clinical practice, treatment modalities for its management, and standards of care. General approaches to the acute GI bleeding patient are discussed in terms of supportive care, early detection, and determination of upper versus lower GI bleed, when to transfuse, as well as early predictors of morbidity and mortality. The authors outline the many dilemmas faced by physicians in their approach to their patients, such as localization of the bleeding source (upper versus lower), the need and timing for emergency endoscopy, and the timing for radiologic intervention or surgery. Each of the chapters concludes with a list of references; a subject index concludes the volume.

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Congenital Bleeding Disorders. IN: Hematology 2003. Washington, DC: American Society of Hematology. 2003. pp. 559-574.

This article reviews some of the clinical and basic problems related to the congenital bleeding disorders that continue to confront hematologists. In the first section, Dr. Christopher Walsh discusses general principles of effective gene transfer for the hemophilias, specific information about viral vectors and nonviral gene transfer, and alternative target tissues for factor VIII and factor IX production. He highlights information about the immune response to gene transfer, reviews data from the hemophilia gene transfer trials to date, and presents outlines of some future prospects for newer methods of therapy such as RNA repair and the use of gene-modified circulating endothelial progenitors. In the second section, Dr. Nigel Key focuses on inhibitor development in patients with hemophilia A, reviewing the progress in understanding the risk factors and the immunobiology of inhibitor development. Topics include the natural history of these inhibitors and the screening, laboratory diagnosis, and treatment, including the use of different modalities for the treatment of acute bleeding episodes. In the final section, Dr. Margaret Rick discusses the diagnosis, classification, and management of von Willebrand disease. Attention is given to the difficulty of diagnosis in patients with mild bleeding histories and borderline laboratory test results for von Willebrand factor. Practical issues of diagnosis and treatment, including clinical cases, are presented. 1 figure. 2 tables. 48 references.

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Epidemiology of Acute Gastrointestinal Bleeding. In: Chung, P. and Kim, K.E. Acute Gastrointestinal Bleeding: Diagnosis and Treatment. Totowa, NJ: Humana Press. 2003. p. 3-7.

Acute gastrointestinal (GI) bleeding accounts for over 300,000 hospitalizations per year and has high morbidity and mortality in those who go undiagnosed. This chapter on the epidemiology of acute GI bleeding is from a textbook in which leading experts in the fields of gastroenterology, surgery, and radiology comprehensively review the pathophysiology, diagnosis, management, and treatment of acute bleeding disorders of the GI tract. The authors of this chapter stress that acute GI bleeding is an extremely common clinical condition affecting a large patient population. The diverse clinical presentations, etiologic factors, and treatment modalities are important to understand, and early identification of the source of bleeding is the essential component in reducing morbidity and mortality. 32 references.

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Helicobacter Pylori and Peptic Ulcer Disease. In: Chung, P. and Kim, K.E. Acute Gastrointestinal Bleeding: Diagnosis and Treatment. Totowa, NJ: Humana Press. 2003. p. 35-56.

Peptic ulcer disease (PUD) is a common gastrointestinal (GI) problem that has a substantial impact on patient well-being and health care costs. Complications include hemorrhage, perforation, and gastric outlet obstruction. This chapter on Helicobacter pylori and PUD is from a textbook in which leading experts in the fields of gastroenterology, surgery, and radiology comprehensively review the pathophysiology, diagnosis, management, and treatment of acute bleeding disorders of the GI tract. Topics covered in this chapter include epidemiology, clinical presentation, diagnosis, etiology, treatment, and bleeding associated with PUD. Peptic ulcer can present silently with complications such as hemorrhage, particularly in patients on nonsteroidal antiinflammatory drugs (NSAIDs). Proton pump inhibitors (PPI) are the mainstays of therapy. Effective eradication of H. pylori involves regimens utilizing multiple antibiotics. Upper endoscopy effectively diagnoses peptic ulcers, reduces rebleeding, and allows for appropriate triage of patients with upper GI bleeding complications. One patient care algorithm is provided. 1 figure. 3 tables. 99 references.

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