Specimen Tube “Head Space” and pH

A colleague asked about an issue with “head space” and surface area in sodium citrate (blue-closure) tubes causing changes in pH with the changes becoming more profound the longer the tube is stored. This then affects test results. My friend had not heard of this before although he knows there are pH changes associated with […]

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Specimen Management

Jan 11 2013

george

VerifyNow Platelet Function Screen?

Attached to the December 28 post, “Platelet Function Testing and the Bleeding Time” with the AC Ivy story was the question, “Is the Accumetrics VerifyNow aggregometer useful for screening patients for inherited platelet function disorders?” Yes, I consider the VerifyNow assay effective in screening for platelet function defects, like storage pool disorder or platelet secretion disorder (aspirin-like syndrome), however […]

Antiplatelet Therapy

More on FVIII Linearity

I spoke with Patti Tichenor, UAB special coagulation laboratory who had discussed our December 5, 2012 factor VIII linearity question from Mahnaz Sairi with her UAB colleague Laura Taylor. UAB uses high-end coagulometers (Stago STA-R) for their factor assays, and their linearity extends from near zero to 100%. When they anticipate especially high factor VIII levels, they will order dilutions to as high […]

Factor Assays

Rivaroxaban and LA?

There are three helpful comments appended to our December 5, 2012 Delta Checks for PT, PTT, Fg, and D-dimer post. One came from “goblue,” whom I surmise is aUniversity of Michigan Wolverines fan (sorry about that South Carolina game): “While administering Xarelto (rivaroxaban), will this give a false positive result on lupus anticoagulant (LA) tests?” Yes, as rivaroxaban […]

Lupus Anticoagulant

FEIBA Inhibitor?

Hi Mr. Fritsma! It’s Milena Jr. How are you? I hope you and Mrs. Margaret had some nice holidays. I’m on my intern year now, and I’ve come to know a patient with hemophilia who has factor VIII inhibitor. I wanted to ask if patients can also create inhibitors to FEIBA? is that why some patients […]

Bleeding Disorders

Correction to December 6 Post

A note from my friend and colleague, John Landis, who retired from the Clinical Laboratory Science faculty at Ferris State University in Big Rapids, Michigan a few years ago: “I just read the new Cheat Sheet and saw the question from Scott Millerand your response. Scott is a graduate of my Ferris State program, but he works at St Mary’s of Saginaw not Grand Rapids. […]

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Anticoagulant Therapy

Jan 4 2013

george

Akers PIFA Kit

From Lynn Gingras, MT (ASCP), Rush-Copley Medical Center: Our institution is getting several complaints from the cardiologists as to the turnaround time of the heparin-induced platelet antibody (HIPA, heparin-induced thrombocytopenia with thrombosis, HIT, HITT) testing that we currently send out to a reference lab. Is there any value to bringing in the Akers Bioscience Particle ImmunoFiltration Assay (PIFA) […]

Arterial Thrombosis

Apixaban Cleared for Afib

After a lengthy delay, the US Food and Drug Administration (FDA) cleared apixaban (Eliquis®, Bristol-Myers Squibb/Pfizer) for prevention of stroke in non-valvular atrial fibrillation on 12.28.12. Apixaban is an oral direct anti-Xa anticoagulant and joins rivaroxaban and dabigatran (a direct thrombin inhibitor) as the third new oral anticoagulant cleared since 2009. Details appear in TheHeart.org.

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Anticoagulant Therapy

Dec 28 2012

george

Platelet Function Testing and the Bleeding Time

In 2009 Dave McGlasson and I published McGlasson DL, Fritsma GA, Whole blood platelet aggregometry and platelet function testing. Semin Thromb Hemost 2009;35:168–80. This article, the second-most cited in the 2009 Seminars in Thrombosis and Hemostasis, reminded me of our Quick Question about the Ivy bleeding time posted in early November, and subsequently lost when our site crashed […]

Bleeding Disorders

Are Prophylactic Platelets Beneficial?

In a plenary session on Sunday, December 9, 2012, Dr. Simon Stanworth reported on a trial of 600 patients being treated for hematologic malignancies, chemotherapy, or stem cell transplants, Stanworth SJ, Estcourt L, Powter G, et al. The effect of a no-prophylactic versus prophylactic platelet transfusion strategy on bleeding in patients with hematological malignancies and severe thrombocytopenia (TOPPS […]

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Bleeding Disorders

All Posts

Specimen Tube “Head Space” and pH

VerifyNow Platelet Function Screen?

More on FVIII Linearity

Rivaroxaban and LA?

FEIBA Inhibitor?

Correction to December 6 Post

Akers PIFA Kit

Apixaban Cleared for Afib

Platelet Function Testing and the Bleeding Time

Are Prophylactic Platelets Beneficial?

George Fritsma MS MLS

Cheat Sheets from George

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