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New thrombosis guidelines

US experts this week issued guidelines to help primary care doctors diagnose and treat venous thromboembolisms (VTEs), which include deep-vein thrombosis and pulmonary embolism.

VTEs are potentially fatal conditions that occur when a blood clot that's formed at one point of the circulatory system detaches and travels to block blood circulation at another point.

A pulmonary embolism occurs when this kind of clot, which usually forms in the veins of the leg, obstructs the pulmonary artery or one of its branches. This can cause acute heart failure or sudden death.

The problem of deep-vein thrombosis gained notoriety when some passengers on long-haul flights came down with the condition, which some have dubbed "economy-class syndrome."

Early treatment saves lives
Treating the condition at an early stage can help save lives and prevent complications such as pulmonary embolism or recurrent deep-vein thrombosis (DVT).

The new guidelines were drawn up by experts at the American College of Physicians and American Academy of Family Physicians.

Key points of the new diagnosis guideline include: the use of clinical prediction rules to establish pretest probability of (DVT) or pulmonary embolism in a patient before further tests are conducted; and the usefulness of different kinds of diagnostic tools such as D-dimer and ultrasonography.

The new management guideline supports the use of low-molecular weight heparin, a blood thinner, for patients with deep vein thrombosis in an outpatient setting when appropriate support services are available.

The new guidelines are expected to be published in the journals Annals of Family Medicine and Annals of Internal Medicine.

"These guidelines provide information on the utility of various diagnostic tools and compare the efficacy and safety of various pharmacologic agents used for treatment of VTE," Dr Amir Qaseem, senior medical associate in the Clinical Programs and Quality of Care department of the Medical Education and Publishing Division at the American College of Physicians, said in a prepared statement. – (HealthDayNews)

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February 2007

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