Patients were categorized by diagnosis into two groups: Haemophilia carriers and all others. Treatment options were grouped into two categories: Medical or gynecological/surgical. Overall, 85.7% of haemophilia carriers required gynaecological surgical management, whereas only 31.4% of patients

with all other diagnoses required gynaecological/surgical management (P = 0.012, Fisher’s exact test). Therefore, carriers of Haemophilia were more likely to have a better outcome in treating their menorrhagia with gynaecological or surgical management compared with medical management. This information may 1 day help to guide treatment choice for menorrhagia in women with bleeding disorders. “
“Summary.  Under the auspices of the United Kingdom Haemophilia Doctors Organisation (UKHCDO) the UK Comprehensive Care Haemophilia Centres (CCCs) have undergone a three yearly Small molecule library formal audit assessment since 1993. This report describes the evolution of the audit process and details the findings of the most recent audit round, the sixth since inception. The audit reports from the 2009 audit round were reviewed by the audit organizing group and a structured analysis of the data was compiled. CCCs in the UK offer a high standard of comprehensive care services. The main areas of concern were the state of the premises

(seven centres), lack of dental services (seven centres), physiotherapy (seven centres) and social work support (11 centres). Major concerns were identified at eight centres Pirfenidone molecular weight requiring a formal letter from the chairman of UKHCDO to the chief

executive of the host trust. Since inception of the triennial audit process centre report recommendations have resulted in major improvements in the services available at UK CCCs. The audit process is considered selleck inhibitor to be a highly effective means of improving the quality of care for patients with bleeding disorders and can be used as a model for the introduction of a similar process in other countries. “
“This chapter contains sections titled: Prevalence and classification Clinical and laboratory diagnosis Conclusions and future perspectives Acknowledgments References “
“The combination of the complexity of the coagulopathy in haemophilia with the relative low frequency of occurrence of the condition poses a formidable challenge to respond to scientific questions. Consequently, the gold standard of care has arisen from tradition and become, by virtue of habit, into paradigms. Under these constrains, when the paradigm is challenged by fragments of data, in the absence of a randomized controlled trial, a negative emotional response is typically generated that may hinder clinical progress. In this study, we will address four subjects where fragmented evidence from basic science studies or advances in achieving reliable coagulation allow challenge of the paradigm.