| The research of this group focuses on the two extremes of blood coagulation. On one hand what are the factors responsible for a thrombotic tendency, i.e. "too thick blood", and what are the clinical consequences with respect to diagnosis, treatment and prognosis, whereas the opposite, i.e. "too thin blood", leads to a bleeding diathesis. Again at this extreme questions related to pathophysiology, diagnosis and treatment are posed. Until recently little was known about the cause of venous and arterial thrombosis. However, in the last 10 years there has been a real explosion in the knowledge regarding hereditary and acquired abnormalities responsible for a thrombotic tendency. Several of these defects are now well characterized and clinical questions about the consequences, i.e. the need for family screening, the impact on treatment and the interaction with hormone treatment and pregnancy need to be answered through careful clinical research. The diagnostic procedures, both for venous thromboembolism and arterial thrombosis, are increasingly becoming non-invasive and combine blood tests and clinical assessment with different imagining techniques. To assess the real value of these methods appropriate clinical studies are needed. Finally, in this area, research is continuing to optimize antithrombotic treatment. With a better insight into the coagulation/platelet cascades several new compounds have become available. Their contribution is largely unknown and comparative studies are required to determine the improvements beyond current therapy. Insights into the physiology of the various cascades has also led to a better understanding of bleeding abnormalities. Several congenital and acquired abnormalities are now well characterized and both the best diagnostic tests needed and the appropriate treatment for these conditions are becoming clearer. Further study is required to understand the role of inflammation and the fibrinolytic system in the setting of hemorrhage (and thrombosis). |
