Intermittent Bleeding, Normal Coags

From Dr. Samir Patel: George, I was wondering if I could get some input from you or any of the other readers regarding a patient in my clinic. This is a 52 year old woman with history of multiple surgeries (dental, orthopedic) and with mixed history of intraoperative bleeding, late bleeding, and no bleeding. She […]

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Bleeding Disorders

Sep 20 2016

george

Quick Question Results: Bethesda Titers

The results of our latest Quick Question are in with 87 responses.. How does your laboratory measure factor inhibitors? Standard Bethesda assay: 33% (26) Bethesda titer using buffered pH 7.4 pooled normal plasma: 9% (8) Nijmegen Bethesda assay using factor-depelted plasma as diluent: 9% (8) CDC modification of Nimegen Bethesda assay: 0% (0) Bethesda chromogenic […]

Bleeding Disorders

Chilling The NBA Reaction Mixture

From Dr. Mirta Arias: Dear George, Thank you for your answer in the blog. I have another question. Dr. Robinson in ISLH argued that it is good to chill the post 2 hour/37°C 37 incubation mixtures of patient + pool normal plasma, and control at 2–8°C for 10 minutes and then measure the factor VIII. In […]

Bleeding Disorders

Nijmegen Bethesda Assay

From Dr. Mirta Arias, Dear George, which is the procedure for determining the cut-off of Bethesda method and Nijmegen? Is there any Excel spreadsheet to perform it? Do you use only normal or normal and patients? Thanks, Mirta Hello, Dr. Arias, and thank you for your question. For a comprehensive answer, I turned to Amanda […]

Bleeding Disorders

CLMA Alabama Chapter Meets August 16

The Alabama Chapter of the Clinical Laboratory Management Association hosts an all-day meeting Tuesday, August 16, 2016 at the Bradley Center of Children’s Hospital of Alabama. George will speak at 10:35–11:45 on “Hemophilia Therapy Management, From Rasputin to Recombinants.” His presentation includes description of the new extended half-life factor concentrates, antithrombin suppression therapy, and gene […]

Bleeding Disorders

Nijmegen-Bethesda Assay Method

Sarah Payne and Kerri Klemm request information on how to perform the CDC modification of the Nijmegen-Bethesda Assay for coagulation factor inhibitors. Thank both of you for your request, which provides George the opportunity for self-promotion. Please tap or click Coagulation Factor Inhibitors and the Nijmegen Bethesda Assay, a recording of my June 2 digital […]

Bleeding Disorders

Undergrad Hemostasis Education

This June 29, 2016 note was posted by Patricia Boyer, MS, MLS, Program Director, Zablocki VAMC School of Medical Technology to the American Society for Clinical Laboratory Science educators bulletin board: I am working on my hemostasis curriculum, and I was wondering how many instructors teach coagulation using the multicomponent complexes–specifically the tenase and prothrombinase complexes concepts. This is my second year […]

Arterial Thrombosis

LABCON Presentation: Coagulation Factor Inhibitors

Hi, this is George writing from LABCON 2016 in beautiful Charlottetown, Prince Edward Island. Tomorrow, Friday, June 16, I will present “Identifying, Measuring, and Treating Coagulation Factor Inhibitors,” sponsored by Precision BioLogic Inc, of Dartmouth, Nova Scotia. I made a few updates to the lecture today, so there are three slides that are not in […]

Bleeding Disorders

Correcting for Hypothermia

From Carla Purvis, MT (ASCP) SH, Parkview Regional Medical Center in Fort Wayne: Hi, George. We have acute care clinicians requesting temperature correction for prothrombin time results for patients who have clinically induced hypothermia. CAP standards state prothrombin times must be performed at 37C. Do you have any references for performing temperature corrections? Thanks. Hi, […]

Bleeding Disorders

New Quick Question: Bethesda Titers

Please review and vote on our May, 2016 Quick Question, “How does your laboratory measure factor inhibitors?” in preparation for our Thursday, June 2 Webinar described below. George will report on your Quick Question findings. If none of the answers reflect your policy, please add a comment to this entry. Please join Precision BioLogic Inc, […]

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Bleeding Disorders

Bleeding Disorders

Intermittent Bleeding, Normal Coags

Quick Question Results: Bethesda Titers

Chilling The NBA Reaction Mixture

Nijmegen Bethesda Assay

CLMA Alabama Chapter Meets August 16

Nijmegen-Bethesda Assay Method

Undergrad Hemostasis Education

LABCON Presentation: Coagulation Factor Inhibitors

Correcting for Hypothermia

New Quick Question: Bethesda Titers

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question