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D-dimer in Pregnancy

From “PVenus” Hi George, At our hospital lab we currently run manual FDPs (Thrombo-Wellcotest) andquantitative D-dimers on the Diagnostica Stago Evolution. We have been trying to come up with justification for eliminating the FDP testing, but our main road block seems to be that quantitative D-dimers are always elevated in pregnancy, especially 3rd trimester, and there are no normal ranges available […]

Indiana Presentation: Monitoring Antithrombotics

I will present Monitoring the New Antithrombotics: Whatever Happened to the PT and PTT? Thursday, September 16, 2010, 7:30 AM to 8:30 AM, at the Indiana University Medical Center Pathology Residents Meeting, Indianapolis, Indiana. Please select the handout below if you would like a printed copy of this information. Geo Monitoring Antithrombotics Handout

Rivaroxaban is Non-inferior in DVT

The results of the EINSTEIN-DVT study, announced on August 31 at the European Society of Cardiology, demonstrated that rivaroxaban (Xarelto, Bayer, Johnson & Johnson) , an oral anti-Xa anticoagulant is as effective and safe as warfarin in treating acute deep venous thrombosis. Xarelto was released for prophylaxis in Northern Europe and Canada in the spring […]

Apixiban Efficacy

Apixiban (Bristol Myers Squibb, Pfizer) efficacy and safety data from the AVERROES study were reported at the European Society of Cardiology meeting August 31, 2010 in Stockholm. Subjects in the study had a significantly lower risk of stroke and systemic embolic events without increase risk of bleeding. Apixiban is one of the new oral anti-Xa […]

Prasugrel Requires No Genetic Studies

At the August 29 European Society of Cardiology meeting in Stockholm, results from two substudies of the PLATO study showed that, unlike clopidogrel, neither prasugrel (Effient, Lilly) nor ticagrelor (Brilinta, Asta-Zeneca) were affected by loss of function mutations of genes for enzymes in the CYP2C19 pathway. This information is likely to affect future antiplatelet drug […]

Heparin Monitoring: Specimen Timing

I received this question today via the American Society for Clinical Laboratory Sciences consumer forum from a hospital pharmacist: Our lab says that heparin drips have to be turned off for 30 minutes before the PTT is drawn, even though they draw the specimen from the opposite arm. Is this true and what is the reason? A […]

Pediatric Specimens

From Teresa Black, Orlando Regional Medical Center Dear George, We are looking for a smaller volume sodium citrate tube for blood collection on our pediatric patients. We are presently using BD 1.8 mL sodium citrate tubes. Is there any collection system that you know of that works as well as the 1.8 mL tubes? Thanks, Teresa Black […]

Coagulation References

Hello, I am a a critical care physician and I find difficulty to approach the bleeding and coagulation results of a patients; any advice? Hello, and thank you for your question. Though self-promotional, I would like to recommend our pocket-size handbook, Marques MB, Fritsma GA. Quick Guide to Coagulation Testing, Second Edition, American Association for Clinical […]

Altitude and Vacuum Tubes

Mary Lou Turgeon, EdD, MLS (ASCP) of Mary L. Turgeon and Associates, posted this question about altitude and blood collection on CLSEduc, the Clinical Laboratory Science educators’ bulletin board on September 1: How do those of you living in the Mile High City or other high altitudes deal with the effect of altitude on the blood […]

Case Study: Protein C and S

A 17-month old child suffered a stroke in July of 2010. The results of a specimen collected ten days after the event showed that his protein C and protein S activities were 54% and 40%. Reference intervals for a child over 1 year old are the same as adults: 65% to 140% for protein C […]

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George Fritsma is a medical laboratory scientist, educator, and author. George is a member of the International Society on Thrombosis and Hemostasis, the International Society for Laboratory Hematology, and the American Society for Clinical Laboratory Science.

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