Is increased plasma von Willebrand factor in the systemic inflammatory response syndrome derived from generalized endothelial cell activation?
We postulate that the increased plasma levels of vWf and the decreased staining in the peripheral dermal plexus represent the generalized activation and degranulation of endothelium in vascular beds remote from the original inflammatory focus.
These results highlight the lack of UK ENT undergraduate education, and the significant effect this has on junior doctors' clinical confidence. In addition, commonly used teaching methods may not be optimally effective.