SUMMARY
The platelet thromboplastic function levels in patients with primary disease of the bone marrow (polycythæmia vera and primary thrombocythæmia) were compared with the findings in patients whose polycythæmia or thrombocytosis was due to a definable underlying disorder.
Of the patients with untreated polycythæmia vera, irrespective of the platelet count, 71% showed reduced platelet thromboplastic function, compared with only 12% of patients with secondary polycythæmia which was uncomplicated by either renal or liver disease. Similarly, the platelet thromboplastic function level was reduced in 100% of patients with untreated primary thrombocythæmia, compared with 47% of patients with elevated platelet numbers secondary to other associated diseases. The platelet thromboplastic function test was therefore useful in differentiating between primary and secondary polycythæmia. Normal platelet thromboplastic function virtually excluded a myeloproliferative disease (thrombocythæmia) in patients with raised platelet counts, irrespective of other hæmatological changes.
The effect of 32P in the two conditions due to primary disease of the bone marrow was to produce a rise towards normal platelet thromboplastic function.
It is considered that the platelet defect in primary thrombocythæmia is a qualitative one, and not, as has been reported by others, a quantitative anticoagulant effect of high in‐vitro platelet numbers.
Summary
Previously published hæmatological data concerning patients with primary, secondary or stress polycythæmia have been analysed by digital computer. The mathematical model utilized is presented, and the results of the analysis have been related to the clinical and laboratory findings. It is emphasized that different mathematical methods of treating the data may produce variable results. Accordingly, the results of computer analysis should be regarded critically and with an awareness of the limitations of the mathematical methods involved.
Complex data are often assembled under less than ideal conditions for subsequent computer analysis. However, the present study concerning previously published hæmatological data indicates that such material may be amenable to certain statistical techniques provided that the subsequent computer results are interpreted carefully.
It is further emphasized that computer analysis of any medical data must involve close cooperation between clinician and mathematician if the resultant information is to be regarded as accurate.
The disciplines of anaesthesia and clinical pharmacology are related in as much as both have a mutual interest in the safe and conservative use of drugs in man. Anaesthetists have effectively been practising rational therapeutics for many years and they have much to offer academic departments of clinical pharmacology in terms of teaching and research programmes. Similarly, the clinical pharmacologist can usefully contribute to anaesthetic training and research programmes in relation to aspects such as education, precise analytical methods, datahandling and clinical trial techniques. The interrelationship of the two disciplines can be of mutual advantage and has the potential to provide a stronger basis for sound therapeutic practice.
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