[Prevention in general practice. Possibilities of preventive examinations--challenges for the general practitioner].
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Blood coagulation results from a sequence of enzymatic reactions, which involve 12 plasma proteins (coagulation factors), platelets, a tissue lipoprotein (tissue factor), vascular components and calcium ions. These reactions are induced by vascular lesions, and are promoted by blood contact with sub-endothelial structures and by the release of tissue factor into the circulation; they result in the formation of an hemostatic plug constituted of platelets and fibrin. The enzymatic reactions consist of proteolytic reactions, in which zymogens are converted to proteinases. These reactions are accelerated by both proteins-proteins interactions and by proteins-membrane surface (vascular wall, platelets) interactions, responsible for the amplification of the activation process, and its localization at the site of injury. The coagulation process is regulated by positive and negative feed-backs and by physiological inhibitors.
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