Coagulation Concepts Update
ABSTRACT OBJECTIVE: Since the previous comprehensive radiology review on coagulation concepts that was done in 1990, many studies have been published in the medical and surgical literature that can guide the approach of a radiology practice. The purpose of this article is to provide an analysis of these works, updating the radiologist on proper use and interpretation of coagulation assessment tools, medications that modify the hemostatic system, and the use of transfusions prior to interventions. CONCLUSION: The basic tools for coagulation assessment have not changed; however, results from subspecialty research have suggested ways in which the use of these tools can be modified and streamlined to safely reduce time and expense for the patient and the health care system.
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ABSTRACT: OBJECTIVE: The purpose of this article is to discuss the history of, indications and rationale for, and approach to imaging-guided percutaneous renal biopsies. CONCLUSION: With the progressive increase in the number of incidentally discovered renal masses, increased use of percutaneous ablation as a treatment alternative for the management of renal cell carcinoma and improvements in immunohistochemistry techniques, imaging-guided renal biopsy will continue to serve as a useful tool for the evaluation and management of renal diseases.American Journal of Roentgenology 06/2010; 194(6):1443-9. DOI:10.2214/AJR.10.4427 · 2.74 Impact Factor
Article: Coagulopathy and the Neurosurgeon[Show abstract] [Hide abstract]
ABSTRACT: An essential component of neurosurgical critical care and routine delivery of neurosurgical services is an understanding of bleeding and clotting disorders. Patients with coagulopathies can present with difficulty forming or maintaining normal clotting or show a hypercoagulable state. Any coagulopathy can have serious consequences in the setting of neurosurgical care including cranial or spinal surgery, trauma, or spinal cord injury. On the basis of the most current peer-reviewed literature, we present recommendations for assessment, treatment, and surveillance of coagulopathy in the neurosurgical patient.Neurosurgery Quarterly 08/2010; 20(3):122-129. DOI:10.1097/WNQ.0b013e3181eb6e59 · 0.09 Impact Factor
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ABSTRACT: Biochemical characterization of the haemostatic system has advanced significantly in the past decades. Sub-systems, such as coagulation, fibrinolysis, blood cells and platelets and the vessel wall have been studied by specialists, mostly separately and independently. The time has come to integrate the approaches, and, in particular, to develop tests to document the state of the whole system and to have available adequate pharmacodynamic tests to evaluate treatments. Many examples are available to show that traditional general methods of clotting and lysis do not provide the information that is desired. The present tendency is to use specific methods for specific factors or effects which are very limited in pharmacological information. There is also increasing awareness of the occurrence of rather broad interindividual variability in the haemostatic system. This suggests that individually tailored treatments are required. This is the more relevant since haemostasis is a balance and treatment should be positioned between efficacy and safety. The conclusion is reached that there is a need for integrated or global methods or sets of methods that reflect the complexity and individual status appropriately and allow the practitioner to judge the effects of interventions and their individual aspects.British Journal of Clinical Pharmacology 02/2011; 72(4):538-46. DOI:10.1111/j.1365-2125.2011.03946.x · 3.69 Impact Factor