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Managing uncertainty: Physicians' decision-making for stroke prevention for patients with atrial fibrillation and intracerebral haemorrhage
Conclusion Physicians described the process of deciding on stroke prevention in patients with AF post-ICH as 'challenging' due to considerable 'clinical equipoise'. Key factors that affected decision-making was patient comorbidities, functional status, and patient willingness to engage with oral anticoagulation therapy. Shared decision-making was believed to be beneficial, but physicians believed that the ultimate responsibility to decide on stroke prevention lay with the clinician.PMID:35253141 | DOI:10.1055/a-1789-4824
Source: Thrombosis and Haemostasis - March 7, 2022 Category: Hematology Authors: Elena Ivany Robyn Lotto Gregory Yh Lip Deirdre Lane Source Type: research

Hydroxyurea Therapy Does Not Impact Current Survival Estimates in the East London Sickle Cell Newborn Cohort Study
Conclusions: The study is the first to evaluate survival in a newborn cohort past the age of 20 years. We have confirmed a low mortality rate in childhood, but increased number of deaths in young adults including those with HbSC. This study provides evidence of the benefit of newborn screening and comprehensive care which is accessible at all ages, free of charge. The uptake of HU, particularly at a young age, has been low and a positive effect of HU on survival as described in other studies has not yet been observed in this cohort. Earlier initiation of disease-modifying treatment and longer-term follow-up will be require...
Source: Blood - November 21, 2018 Category: Hematology Authors: Telfer, P., Kaya, B., Tsitsikas, D. A., Barroso, F., Sangarappillai, C. Tags: 114. Hemoglobinopathies, Excluding Thalassemia-Clinical: Poster III Source Type: research

Transcranial Doppler Screening in a Regional Care Network for Sickle Cell Disease in the United Kingdom
The risk of stroke in children screened with transcranial Doppler ultrasound in the United Kingdom is not known. We evaluated a clinician-led program using a risk assessment modified from the STOP protocol. High-risk classification included abnormal velocities in the anterior cerebral artery, and single abnormal scan if initial velocity>220 cm/s (high abnormal) or if preceded by at least 2 conditional scans. In total, 1653 scans were performed in 542 children, followed for 2235 patient-years. Fifty-eight (10.7%) high-risk subjects were identified, including 18 (31%) with high abnormal, and 15 (26%) with previous conditiona...
Source: Journal of Pediatric Hematology Oncology - September 30, 2016 Category: Hematology Tags: Original Articles Source Type: research