Publication of october 2023

  • "Soins palliatifs pédiatriques
  • Otite moyenne aiguë en soins primaires
  • Vascularites
  • COVID long: l'importance d'informer
  • Agressions sexuelles sur les très jeunes enfants
  • Ama Contacts - 187e Promotion des Médecins de l’UCLouvain

 

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Hematology/Oncology

Focus on suspected hemorrhagic diathesis

Clinical bleeding manifestations are commonly encountered reasons for medical consultations in both general and specialized fields. A comprehensive medical history, encompassing personal and familial contexts, plays a pivotal role in predicting a bleeding disorder. Employing a bleeding clinical score constitutes the primary approach. While routine coagulation tests are useful, they are inadequate for definitively ruling out a potential hemostatic abnormality. If a strong suspicion of hemostasis dysfunction exists, a comprehensive array of biological assessments must be requested. This evaluation should encompass primary hemostasis, coagulation factors, and fibrinolysis. This combined clinical and biological strategy is instrumental in recognizing whether a coagulation disorder is acquired or hereditary, in elucidating its underlying cause, and in gauging its severity. The commonly encountered congenital causes comprise platelet functional disorders, von Willebrand disease, hemophilia A/B, and deficiencies in coagulation factors like Factor VII and Factor XI, as well as hyperfibrinolysis. Nonetheless, a notable subset of patients is unlikely to benefit from this diagnostic approach. This prompts us to an undetermined source of the bleeding tendency, necessitating cautious attention to its potential implications. For hemostatic interventions, it is crucial to exercise vigilance. Indeed, the aim of such procedures is to attain effective management or bleeding prevention, while sidestepping unnecessary treatments with inherent risks, such as allergies, immunization, infections, and even thrombotic complications.

 

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STOPP/START.v2

The tool STOPP / START.v2 allows evaluation of drug treatments prescribed to patients age 65 and older.

 

This tool, designed for all care settings, stimulates thinking and challenging medication taken by patients, especially drugs forcardiovascular and nervous system.

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