title: Haemophilia at various stages of life: design of new therapeutic strategies through an interactive course--the Kogeniale project.
abstract: BACKGROUND
  High-quality evidence is lacking in several areas of haemophilia treatment, in part because little time is allocated to the treatment and care of haemophilia in university education in Italy. Physicians caring for patients with haemophilia must, therefore, rely on their information on background pathophysiology and more experienced colleagues. This makes diagnostic and therapeutic choices difficult, especially when the patient has concomitant disorders or psychological issues.
  
  
  METHODS
  This article describes a course to educate young physicians who were already engaged in the management of haemophilia on the emerging and unmet issues of haemophilia care and to implement existing guidelines. Physicians (n=53) already caring for patients with haemophilia in their haematology, internal medicine, or paediatric practices in Italy attended the course. Problem-solving group activity and open discussion were the methods chosen to formulate consensus statements. During the specifically designed interactive course, three clinical cases were simulated: a young child with congenital dislocation of the hip, an adolescent refusing prophylactic treatment, and an elderly man with cardiovascular disorders. The physicians were asked questions during the course and, through a Wi-Fi console, were able to answer and discuss each case interactively.
  
  
  RESULTS
  Following discussion of each case, agreement was reached regarding general statements on the management of patients with severe haemophilia A in the three different age ranges considered.
  
  
  CONCLUSIONS
  This project helped to outline useful decision-making tools for handling diagnostic and treatment issues in the field of haemophilia.
authors: Angelo Bianchi Bonomi Haemophilia and Thrombosis Centre, Department of Medicine and Medical Specialties, University of Milan and Istituto Di Ricovero e Cura a Carattere Scientifico Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Milan, Italy.
authors: Elena
authors: E
authors: Santagostino
authors: Maria
authors: M
authors: Messina
authors: Annarita
authors: A
authors: Tagliaferri
authors: Alfonso
authors: A
authors: Iorio
authors: Massimo
authors: M
authors: Morfini
mesh_terms: D000293:Adolescent; D000368:Aged; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000150:complications; D003110:Colonic Neoplasms / Q000150:complications; D005260:Female; D006405:Hematology / Q000193:education*; D006467:Hemophilia A / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006617:Hip Dislocation / Q000150:complications; D006801:Humans; D007223:Infant; D007596:Joints / Q000503:physiopathology; D008297:Male
chemical_list: D001779:Blood Coagulation Factors
references: Pain. 2009 Sep;145(1-2):169-75
references: 19573989
references: Haemophilia. 2001 Nov;7(6):544-50
references: 11851751
references: Blood Transfus. 2008 Sep;6 Suppl 2:s17-20
references: 19105505
references: Blood. 2000 Jul 15;96(2):437-42
references: 10887103
references: J Thromb Thrombolysis. 2011 Nov;32(4):439-47
references: 21818664
references: Thromb Haemost. 2009 Apr;101(4):674-81
references: 19350110
references: Haemophilia. 2008 Sep;14(5):945-51
references: 18540895
references: Haemophilia. 2006 Jul;12 Suppl 3:8-12
references: 16683991
references: Haemophilia. 2009 Jul;15(4):894-9
references: 19473414
references: Haemophilia. 2008 Sep;14(5):1035-8
references: 18637967
references: Haemophilia. 2009 Jan;15 Suppl 1:15-9
references: 19125936
references: Chest. 2008 Jun;133(6 Suppl):546S-592S
references: 18574273
references: J Thromb Haemost. 2009 Feb;7(2):247-54
references: 18983484
references: Thromb Haemost. 2010 Mar;103(3):596-603
references: 20076854
references: Haemophilia. 2010 Nov;16(6):955-6
references: 20579114
references: Haemophilia. 2009 Jan;15(1):227-39
references: 18752535
references: Haemophilia. 2010 Jan;16 Suppl 1:13-9
references: 20059564
references: J Thromb Haemost. 2010 Jan;8(1):83-9
references: 19817995
references: Cochrane Database Syst Rev. 2011 Sep 07;(9):CD003429
references: 21901684
references: Bull World Health Organ. 1995;73(5):691-701
references: 8846496
references: J Pediatr Hematol Oncol. 1999 Jul-Aug;21(4):289-95
references: 10445891
references: Epilepsia. 2009 Jan;50 Suppl 1:2-6
references: 19125841
references: Circulation. 2007 Aug 14;116(7):e148-304
references: 17679616
references: Br J Haematol. 2005 Jul;130(1):107-12
references: 15982352
references: J Thromb Haemost. 2007 Aug;5(8):1624-9
references: 17663735
references: Haemophilia. 2007 Sep;13 Suppl 2:10-5
references: 17685918
references: Br J Haematol. 2010 May;149(4):498-507
references: 20230411
references: Haemophilia. 2010 May;16(3):437-46
references: 20148978
references: Haemophilia. 2009 May;15(3):639-58
references: 19444969
references: Haemophilia. 2006 Jan;12(1):75-81
references: 16409179
references: J Pediatr Health Care. 2008 Sep-Oct;22(5):318-22
references: 18761234
references: Pediatrics. 2008 Jun;121(6):1281-6
references: 18519501
references: Haemophilia. 2008 Jul;14 Suppl 3:188-95
references: 18510541
references: Chest. 2008 Jun;133(6 Suppl):381S-453S
references: 18574271
references: Haemophilia. 2009 Jan;15(1):184-92
references: 18702617
references: Haemophilia. 2009 Jan;15 Suppl 1:20-7
references: 19125937