CAP Questions on Carryover

From Kim Kinney (Clarian), I received the attached response from IL regarding one of the new College of American Pathologists (CAP) questions, HEM25175, which requires pipettes be checked for carryover after repairs or maintenance. I am also awaiting documentation for HEM25150, which requires that accuracy be checked annually.

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Oct 7 2010

george

Low Phospholipid PTT Reagent

Another excellent question from “Elhosenymohamed” How can the dilution of the phospholipid component of the partial thromboplastin time (PTT) reagent detect antiphospholipid antibodies? Hello, again, Dr. Mohamed, and thank you for your question. Most of the PTT reagents we use for monitoring unfractionated heparin or for performing routine coagulopathy screens are formulated with a relatively […]

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Low Dose Heparin and the PTT

From “elhosenymohamed”: Why does not heparin in prophylactic doses affect the PTT? and if it does not affect the coagulation profile, how does it protect against thrombosis? Why does not enoxaparin or LMWH in general affect the PTT? Hello, Dr. Mohamed, and thank you for another thought-provoking pair of questions. Low dose unfractionated heparin, administered […]

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Flash-freezing in IPA/Dry Ice

Here is a challenging question from Anne-Marie Quinn, Janssen-Ortho Canada: Hi, I am starting up a PK study at a new facility that has not done flash freezing of plasma samples before. I want them to flash freeze in an isopropyl alcohol-dry ice bath, but I am unable to find any standard method that specifies […]

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Prekallikrein Deficiency and Nosebleeds

From Kim Kinney at Clarian in Indianapolis: We have a case of a 2-year-old girl with spontaneous nose bleeds and 80-100 second partial thromboplastin times (PTTs). Normal von Willebrand factor VWF test results, normal platelet studies, but less than 1% prekallikrein (PK, Fletcher factor). She is on Amicar as needed. Very few cases listed in […]

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Dabigatran Recommendation

On September 20, an FDA advisory panel unanimously recommended approval for Dabigatran (Pradaxa, Boehringer-Ingelheim) prophylaxis to prevent stroke in atrial fibrillation, as reported by Heartwire’s Steve Stiles. Dabigatran, an oral direct thrombin inhibitor, joins Rivaroxaban (Xarelto, Johnson & Johnson) an oral direct factor Xa inhibitor, as one of two new FDA panel-recommended oral antithrombotics that threaten to push […]

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Prekallikrein Protocol for STAR

In response to a September 22 post requesting a prekallikrein assay protocol for the Diagnostica Stago STAR, my colleague and noted coagulation researcher Dave McGlasson went back into his archives at Wilford Hall USAF Medical Center and found the attached protocol. He scanned pages 1 and 2 into the first file, page 3 of the protocol is in the second file. […]

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Platelet Aggregometry Interpretation

Dear George, I am a student and I would like to ask for your help regarding a platelet aggregometry question. If the graph shows no reaction to the agonists ADP, epinephrine and ristocetin what does that mean? Thank you. Maria Carmis. Hello, Maria, and thank you for your question. If you happen to be using the […]

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Prekallikrein Assay On STAR

Dear George: Do you have any experience or do you know of another institution that has tried to implement a clotting assay for the prekallikrein (Fletcher) factor assay on the STAR-Evolution? Hello, and thank you for your question. We send out our prekallikreins, have never set them up on our STARs. Can anyone out there can […]

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Prasugrel and Ticagrelor Superior to Clopidogrel

A meta-analysis designed to compare the efficacy and safety of prasugrel with ticagrelor may have turned up few differences between the two but did show composite superiority to clopidgrel. The article Biondi-Zoccai G, Lotrionte M, Agostoni P, et al. Adjusted indirect comparison meta-analysis of prasugrel versus ticagrelor for patients with acute coronary syndromes. Int J Cardiol 2010. […]

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All Posts

CAP Questions on Carryover

Low Phospholipid PTT Reagent

Low Dose Heparin and the PTT

Flash-freezing in IPA/Dry Ice

Prekallikrein Deficiency and Nosebleeds

Dabigatran Recommendation

Prekallikrein Protocol for STAR

Platelet Aggregometry Interpretation

Prekallikrein Assay On STAR

Prasugrel and Ticagrelor Superior to Clopidogrel

George Fritsma MS MLS

Cheat Sheets from George

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