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Extended Half-life FVIII & FIX and the PTT

From Carolyn McCarville: Hi George, My small laboratory is trying to figure out the best management of coag samples from patients receiving extended half life factor replacement products. We understand that many of the one stage clotting factor assays are inaccurate for the wealth of these products. One thing that we cannot get a straight […]

Bleeding Disorders

Blue-closure Tube Shortage

Thanks to Dave McGlasson for a link to Facebook page, Medical Laboratory Science Hidden Heroes where on May 14, Amy Irwin asked, “So from what I hear the Na citrate blue top tube shortage is nationwide. What is your plan for anyone experiencing this?” Checking an April 16 NPR News report, there is a nationwide […]

Specimen Management

bigEndothelin-1

Here is a significant study of a plasma component associated with thrombosis in immune thrombotic thrombocytopenic purpura published by a colleague and friend, Dr. X Long Zheng, an iTTP expert, and his associate, Dr. Nancy Lu: Lu R, Zheng XL. Plasma levels of bigEndothelin-1 are associated with renal insufficiency and in-hospital mortality of immune thrombotic […]

May, 2021 Quick Question: Flaujeac Factor

This month’s Quick Question is for historical fun, looking back at some of the original coagulation factor names that first used the names of the first families with the factor’s deficiency. Recall the name Flaujeac factor and identify what we call it today.

Coagulation Factors

April 2021 Quick Question: Andexanet Alfa Response

Thanks to our 31 participants for answering the April, 2021 Quick Question, “What test do you employ to validate the need for andexanet alfa to reverse DOAC overdose?” Here are our responses: PT: 3% [1] PTT: 17% [5] Chromogenic anti-Xa: 77% [24] DOAC Dipstick: 3% [1] This question arose from a conversation with the director […]

Anticoagulant Therapy

Covid Coag: Thromboinflammation Talk

On Thursday, April 29, 7–8 CDT, George presents for the American Society for Clinical Laboratory Science–North Dakota via Zoom, “COVID-Coag: What the Heck is “Immuno-thrombo-inflammation?” Here is the updated six-per-page handout for my presentation.

Let’s Use “VITT”

ISTH has chosen the title, Vaccine-induced Immune Thrombotic Thrombocytopenia [VITT] for the adverse event we identified as VAPIT on 4/15/21. ISTH has drafted the attached Interim Guidance for Diagnosis and Treatment of VITT [click]. Watch Fritsma Factor regularly for updates to this document as events unfold.

What is VAPIT?

Since the April 14 meeting of the CDC‘s Advisory Committee on Immunization Practices [ACIP, click], information has become available about “Vaccine-Associated Prothrombotic Immune Thrombocytopenia” [VAPIT, or the ultimate name and acronym the scientific community ultimately settles on, if any]. Some vaccine adenovirus vectors may induce a rare autoimmune response that appears to associate with platelet […]

Dr. Elizabeth “Betsy” Van Cott

Just received this sad news forwarded by Bob Gosselin: Dear MGH Pathology colleagues, We are writing to share the terribly sad news that our dear colleague, Dr. Betsy Van Cott, passed away yesterday morning. Betsy was known, respected and cherished by so many of us—for her clinical skills, for her gentle demeanor, for her deep […]

Medical Laboratory Professionals Week

Help us celebrate Medical Laboratory Professionals Week, April 18–24. Be sure to thank you Medical Laboratory Profession for their service throughout the pandemic and on into 2021.

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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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