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Keywords: Checklist Individual Strength; CIS, fatigue; fatigue questionnaire; immune thrombocytopenia EN Checklist Individual Strength CIS, fatigue fatigue questionnaire immune thrombocytopenia e41 e44 4 04/28/22 20220501 NES 220501 Patients with immune thrombocytopenia (ITP) rate fatigue as the most frequent and/or severe symptom.1 Furthermore, fatigue was found to change very little between the diagnosis and a median of five years later, at the completion of the questionnaire. The cut-off for severe fatigue is >=35 for the CIS-fatigue subscale and >=18 for the shortened CIS, both of which serve as a screening tool with a high sensitivity (0.98 and 0.99) and a slightly lower specificity (0.83 and 0.83, respectively).7,8 The CIS was compared with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Severe fatigue, as measured with the CIS-fatigue, was present in 33 (56%) of the ITP patients, which was significantly higher in ITP patients than in the general population (24%), corrected for age and gender ( I p i < 0.001). The aim of this study was to validate the CIS, CIS-fatigue, and shortened CIS in adult chronic ITP patients and to estimate the prevalence of severe fatigue and compare this with the general population. [Extracted from the article]

Summary: Congenital platelet disorders (CPDs) are rare bleeding disorders that are associated with mucocutaneous bleeds. However, data on vaginal bleeding in women with CPDs are scarce. A set of generic and bleeding‐specific questionnaires were used to evaluate the prevalence of vaginal bleeding, its impact on quality of life (QoL) and sexual functioning and the consequences for pregnancy, miscarriage and delivery in a cohort of women who were referred for diagnostic evaluation for CPDs. A total of 78 women included in the study were either diagnosed with a CPD (n = 35) or were clinically suspected of a CPD (n = 43). Heavy menstrual bleeding (HMB) was reported by a large proportion of women, which mainly started at menarche. In all, 76% of women received any kind of HMB treatment, often leading to surgical prodecures. HMB was shown to have a high impact on QoL, which improved upon treatment. Even though women reported that vaginal bleeding affects sexuality, this topic is not frequently discussed with physicians. Heavy blood loss frequently occurred after miscarriage/delivery, often requiring treatment. Women with (suspected) CPDs frequently encounter HMB, negatively impacting daily life and sexual functioning. Together with peripartum bleeding, these data highlight the burden of vaginal bleeding in CPDs and importance of adequate treatment. [ABSTRACT FROM AUTHOR]

The combined strategy of a pretest clinical probability (PCP) score andd-dimer has shown to be of value in the diagnosis of deep vein thrombosis (DVT). Asd-dimer concentrations increase with age, the effect of age on the usefulness of this strategy was retrospectively investigated in outpatients suspected of having DVT. In all patients, participants of a prospective management trial, a PCP score andd-dimer (Tina-quant®) were performed. In a total of 812 patients, 317 (39%) had thrombosis. Patients were divided into quartiles according to their age. Sensitivity and negative predictive value of a low/moderate PCP score and a normald-dimer were 98–100% and did not differ between the different age quartiles. Specificity in the highest quartile was 17·4% compared with 49·2% in the youngest (P < 0·000001). The proportion of patients with a low/moderate PCP score and a normald-dimer decreased with age: 12% in the highest quartile (>73·8 years)versus25% in younger patients (P = 0·00005). We therefore conclude that the combined strategy of a low/moderate PCP score with a normald-dimer test is safe for excluding DVT in all age groups, but is less useful in the elderly. [ABSTRACT FROM AUTHOR]