This week my son Isaac had surgery on his knee for a dislocated patella. Fortunately it all went well, but he will be in plaster for the next 5 weeks. Shouldn't he have anticoagulant prophylaxis to prevent a blood clot? In Adults knee surgery is associated with a high risk of thrombosis and many international guidelines suggest giving prophylaxis for several weeks after knee … [Read more...]
Clots in pregnancy – How common?
Pregnancy Deep vein thrombosis and pulmonary embolus are serious complications of pregnancy. They are potentially life-threatening and can lead to long-term complications. Pulmonary embolus is the commonest cause of maternal death in most developed countries, so being aware of the risks and signs is very important. Increased risk of clotting Pregnancy is sometimes referred … [Read more...]
Risk factors: thrombophilia – Prothrombin 20210 mutation
The Prothrombin 20210 mutation is found in about 2% of Caucasian people and is very rare in other populations. It is regarded as a very minor risk factor for DVT or PE and only increases the risk of thrombosis about 2 fold. This is less than the risk of taking an oral contraceptive and is similar to the risk associated with smoking. In fact some people believe it is a normal … [Read more...]
In case of emergency – Open Fridge!
You may remember us saying that Angela's parents (aged 85 and 86) emigrated from UK to New Zealand in September last year. They have settled very well into a retirement village and follow all the recommendations put to the residents. I thought one of these recommendations was such a good idea that I'd share it with you all and that is to keep health details readily available in … [Read more...]
The ‘F’ Words of Coagulation – Coagulation Science
A few weeks ago we started a series on the science of coagulation with a post on Taking the Pxxs. This was about the first stage of clotting called primary Haemostasis. In this post I am going to introduce the next phase. If you have ever studied any physiology and had to learn about blood coagulation I suspect you found it a bit complicated. I know from teaching medical … [Read more...]
Risk Factors: thrombophilia – Factor V Leiden
The factor V Leiden mutation is found in about 4% of Caucasian people; that is 1 in 25 people, which means you probably know somebody with this condition. Although it increases your risk of having a blood clot, the vast majority of people with this condition never have a clot. If 1 in 25 people had a blood clot I would be really busy! This mutation was discovered in Leiden … [Read more...]
Australian Open and pulmonary embolism
This week some big names were winners at the Australian Tennis Open. Roger Federer won his 18th Grand Slam at the ripe old age of 35 yrs and Serena Williams once again took the Women's title. I guess that most of my readers would regard the age of 35 as young, but in a high speed sport like tennis, Federer is getting a bit old to be playing at the top level of the game. He is … [Read more...]
Risk Factors: Thrombophilia – Protein S Deficiency
Protein S Protein S is another protein in the blood that works like a natural anticoagulant. It was discovered in Seattle, hence the name Protein S. Like Protein C and many of the clotting proteins it requires vitamin K for normal activity. It is present in the blood in two forms either bound to another protein called C4b-binding protein or as a free protein. Protein S works … [Read more...]
Risk Factors – Thrombophilia: Protein C deficiency
Protein C Protein C was discovered in the 1970s by Stenflo, a scientists working on plasma from cows. He was interested in the proteins that required vitamin K to function properly. He was doing an experiment separating vitamin K dependent proteins in bovine plasma using ion-exchange chromatography. During these experiments he found a protein not previously identified that … [Read more...]
Risk Factor – Thrombophilia: Antithrombin deficiency
Family History Since the first report, hundreds of families have been identified with antithrombin deficiency, but it is still quite a rare condition and only affects about 1 in 5000 people. It is found in about 2 to 3% of people who have a blood clot before the age of 40yrs. Research A great deal is now know about antithrombin. The DNA sequence is known and the molecular … [Read more...]