Intravenous Lovenox and PTT

Dana Haas at St. Luke’s Episcopal Hospital in Houston, TX asks about the effect of Lovenox on the ACT and PTT… In our institution they have started giving patients Lovenox through IV lines (just one shot, not a constant infusion) for patients going for heart catherization. MDs have noticed that Lovenox is prolonging their ACTs […]

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Nov 12 2007

george

Discard Tubes for Factor Assays

Donald R. Peven, MD, of Pontiac, MI extends the question of discard tubes to their use for factor assays. He writes… What is the current practice concerning drawing a waste tube before coag specimens when doing venipuncture? Our understanding is that the NCCLS (CLSI) guideline says that it is OK to draw PTs and PTTs […]

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Does Aspirin Block All Platelet Activity

Janice Richardson asks, “I know that once you have taken aspirin, a platelet cannot produce thromboxane A2. Can this same platelet be activated in another way, say through the thrombin receptor on the platelet? Thanks for your help.” Thank you for your question, Janice. Yes, aspirin acetylates platelet cyclooxygenase and slows thromboxane A2 production. Thromboxane […]

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The Effect of Argatroban on Factor Assays

On September 22 I received an e-mail question from “JLile” asking if Argatroban affects the outcomes of coagulation factor assays. Argatroban (Novostan) is an intravenous direct thrombin inhibitor indicated as an alternative to heparin in patients suspected of developing heparin-induced thrombocytopenia with thrombosis (HIT). The laboratory monitors argatroban using the partial thromboplastin time test (PTT, […]

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Dengue Fever and the PTT

Sachin Kale, MD of Aurangabad, Maharashtra, India asks about prolonged partial thromboplastin time (PTT, APTT) results in children with dengue fever. Here is his question… Hello Everybody, Here, we are getting many children with suspected dengue, they are having thrombocytopenia, normal or near normal PT and prolonged aPTT (more than 2 times control). I have […]

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Pentapharm Pefakit FXIII Incorporation Assay

Pam, I may have found an alternative factor XIII assay that helps answer your September question. Centerchem… in Norwalk, CT distributes the Pentapharm Factor XIII Incorporation Assay. The assay uses the “Kohler” technique, “based on the incorporation of the amine substrate 5-(biotinamido)pentylamine (BAPA) into immobilized fibrinogen by thrombin activated factor XIIIa. The incorporated BAPA is […]

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Adjusting for Hematocrit

CLSI Standard H-21A4 requires citrate volume adjustment when the hematocrit exceeds 55%. Yesterday, Terry Kotrla, MS MT (ASCP) BB, chair of the MLT program at Austin Community College posted a thought-provoking reference on Medlab-L, a 2005 MLO article by Roy Midyett elucidating and challenging this practice. I am curious about how we go about managing […]

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Two Convenient Specimen References

Here are two informative specimen management links… …I learned about through a message from Mike Collins, BMS3, Clinical Biochemistry and Haematology, Norfolk and Norwich Hospital, Colney Lane Norwich NR4 7UY posted on the Medlab_L bulletin board: The World Health Organization pamphlet: Use of Anticoagulants in Diagnostic Laboratory Investigations and Stability of Blood, Plasma and Serum […]

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Type 2 Antithrombin Deficiency: Dr. Moll

As you can see, I’ve been stumped by Dr. Moll’s question. I’ve reviewed assay menus for my favorite hemostasis laboratories… …in the US and Canada, including Esoterix, Machaon, Nichols, MidwestCoag, ARUP, and Hemostasis Reference Laboratory. All offer an antithrombin (ATIII) activity and immunoassay, but none has a phenotypic assay for type IIb deficiency nor genotypic […]

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Anticoagulation Forum and CYP2C9

Kim Kinney’s response about monitoring for CYP2C9 polymorphisms reminded me of last summer’s Anticoagulation Forum exchange between… …Dr. David Garcia, Anticoagulation Forum president and Lawrence J. Lesko, PhD, FCP regarding the FDA’s plan to require information in the Warfarin package insert about genomic testing. There are some differences of opinion about the efficacy of genomic […]

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Intravenous Lovenox and PTT

Discard Tubes for Factor Assays

Does Aspirin Block All Platelet Activity

The Effect of Argatroban on Factor Assays

Dengue Fever and the PTT

Pentapharm Pefakit FXIII Incorporation Assay

Adjusting for Hematocrit

Two Convenient Specimen References

Type 2 Antithrombin Deficiency: Dr. Moll

Anticoagulation Forum and CYP2C9

George Fritsma MS MLS

Cheat Sheets from George

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