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Maureen Andrew - Thromboembolic complications during infancy and childhood, Volume 1

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Every year, there are several hundred thousand episodes of neonates and children experiencing thromboembolic incidents. These episodes of blood clotting have many causes, some congenital but most caused by underlying problems, such as arterial disease, renal disorders, systemic lupus erythematosis or leukemia. Many more are caused by therapeutic interventions in critical care. The author is a world recognized expert on the topic who has studied thousands of cases. Based on this clinical research, the author provides guidelines for the proper diagnosis and therapeutic interventions for thrombolic disorders, no matter what the cause. She covers the newest drug therapies including oral anticoagulation preparations.

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Page iii
Thromboembolic Complications during Infancy and Childhood
Maureen Andrew, MD, RFCP
Professor of Pediatrics
McMaster University Medical Center
Hamilton Civic Hospital's Research Center, Hamilton
Director, Children's Thrombophilia Program
The Hospital for Sick Children, Toronto
Paul T. Monagle, MBBS, MSc, RFACP, FRCPA
Head, Haematology Laboratory
Divisional Director Laboratory Services
Women's and Children's Health Care Network
Senior Lecturer, Department of Paediatrics
University of Melbourne, Melbourne, Australia
Luann Brooker, RT
McMaster University Medical Center, Hamilton
The Hospital for Sick Children, Toronto
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Page iv
Disclaimer:
This netLibrary eBook does not include the ancillary media that was packaged with the original printed version of the book.
Thromboembolic complications during infancy and childhood Volume 1 - image 3
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All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
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Notice: The authors and publisher have made every effort to ensure that the patient care recommended herein, including choice of drugs and drug dosages, is in accord with the accepted standard and practice at the time of publication. However, since research and regulation constantly change clinical standards, the reader is urged to check the product information sheet included in the package of each drug, which includes recommended doses, warnings, and contraindications. This is particularly important with new or infrequently used drugs.

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Page v
The authors would like to dedicate
Thromboembolic Complications during Infancy and Childhood
to our children:
Laura, Kate, Sara and Andrew Monagle;
Neal and Anya Brooker;
Michelle and Adam O'Brodovich
and in memory of
Robbie Andrew O'Brodovich (1982-1986)
whose brief life brought so much joy.

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Page vii
Preface
The concept idea of writing a book devoted to the subject of thromboembolic disease during infancy and childhood arose from numerous conversations that I have had with pediatricians caring for children with these complications; my own practice at the Hospital for Sick Children, Toronto, Canada; and a paucity of information in the literature. Over the last 30 years tertiary care pediatrics has witnessed unparalleled advances in therapy for children with previously lethal disorders which include prematurity, congenital heart disease, cancer, organ failure, and other diverse illnesses. At the same time we have witnessed the evolution of new diseases secondary to the longer survival and treatment of children with these previously lethal diseases. Thromboembolic events, which are primarily secondary to venous and arterial catheterization or use of prosthetic materials, are among the most frequent and serious secondary complications and require specific strategies for both prevention and treatment. Over the same time frame there has been an explosion of knowledge at the molecular level resulting in the discovery of a genetic basis for several congenital prothrombotic disorders. The latter has resulted in the identification of many asymptomatic children with congenital prothrombotic disorders, and who may be at increased risk for thromboembolic disease in the presence of an acquired risk factor. I have attempted to address many of these issues and to make this book a practical one which clinicians can use to determine a reasonable course of action for the investigation and treatment of thromboembolic disease in pediatric patients.
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