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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 […]

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 […]

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 […]

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. […]

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 […]

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 […]

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. […]

Indiana Presentation: Hemostasis in Trauma

I will present Managing Acute Coagulopathy of Trauma and Shock Thursday, September 16, 2010, 11:30 AM to 12:30 PM, at the Indiana University Medical Center Pathology Grand Rounds, Indianapolis, Indiana. Please select the handout below if you would like a printed copy of this information. Geo Hemostasis in Trauma Handout

Antithrombotics: Savannah (Updated 9-21-10)

I will present “Monitoring the New Antithrombotics; Whatever Happened to the PT and PTT?” on Thursday, September 23, 2010, 3 to 4:30 PM at “Meet Me in Savannah,” the American Society for Clinical Laboratory Science Region III Triennialmeeting at the Coastal Georgia Center. The handout that is linked below was updated on 9-21-10, please discard your previous copy. […]

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 […]

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

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