Quick Question Archive

Clot Detection in Whole Blood Specimens

I (Geo) received this message on 11-27-24 from Dr. Ludwig Albornoz: After a simple search on Google, we landed on your website, regarding a practice of detecting and removing fibrin and or blood clots in clinical laboratory blood specimens by using a mechanical method, either plastic or wooden rods, which I introduced for use in […]

Specimen Management

November 2024 Quick Question: History

Our November Quick Question, seen on the right, is a simple quiz with one correct answer. Please comment on your response or add your favorite historical anecdotes.

October 2024 QQ Summary: When Do You Order a Bethesda Titer?

This is a follow-up to our 9-30-24 post introducing our October Quick Question, “At what FVIII activity level do you order a Bethesda inhibitor assay (Nijmegen-Bethesda Assay, NBA)?” It occurred to me (Geo) that the demand for NBAs may have diminished with the 2017 release of HemLibra® (emicizumab), the FVIII bypassing therapy, to be followed […]

Bleeding Disorders

More on Nijmegen-Bethesda Test Volumes

From Ali Sadeghi-Khomami PhD, Precision BioLogic scientist. Access to national and global testing databases is needed to answer the NBA test order volumes question. I am unsure if such a database exists, but relevant data could also be retrieved from insurance companies to estimate the annual rate of NBA inhibitor assays. Yearly marketing report documents […]

Bleeding Disorders

Nijmegen-Bethesda Test Volumes

This is a follow-up to our 9-30-24 post introducing our October Quick Question, “At what FVIII activity level do you order a Nijmegen-Bethesda inhibitor assay (NBA)?” It occurred to me (Geo) that the demand for NBAs may have diminished with the advent of the FVIII bypassing therapies, HemLibra® (emicizumab), soon to be followed by MIM8 […]

Bleeding Disorders

October 2024 Quick Question: Inhibitors

A 9/5/24 question from Chad Siniard, MD, director of the University of Alabama at Birmingham Hospital coagulation service, generated a discussion on the FVIII level that a facility chooses to generate an order for a Nijmegen-Bethesda FVIII inhibitor assay. Our October 2024 Quick Question (on the right) is a poll that asks, “At what FVIII […]

Bleeding Disorders

September 2024 Quick Question Response: PTT and FVIII Level

Our September 2024 Quick Question drew 59 responses and asked: “At what FVIII activity level should the PTT become prolonged?” Our answers were: 60 U/dL: 6 (10%) 40 U/dL: 37 (63%) 10 U/dL: 12 (20%) 1 U/dL: 4 (7%) Most of us chose the correct answer. The PTT “partial thromboplastin” manufacturers develop their reagent to […]

Bleeding Disorders

September 2024 Quick Question: PTT

I (Geo) prefer PTT to APTT or aPTT because the “A” or “a” is superfluous. Laboratory scientists no longer offer an “unactivated” PTT. The “partial thromboplastin” reagent consists of a phospholipid or combination of phospholipids that may include animal, plant, or synthetic sourced phosphatidylserine, phosphatidylcholine, phosphatidylinositol, sphingomyelin, and/or phosphatidylethanolamine. Accompanying the phospholipid is one of […]

August 2024 Quick Question Summary: Rebalancing Therapy

Our August 2024 Quick Question, which attracted 18 responses, asked, “Which hemophilia ‘rebalancing’ therapy suppresses antithrombin RNA production?” Here are your answers: Efanesoctocog alfa: 0 Concizumab: 3 (17%) Octavian 2 (11%) Hemgenix 3 (17%) Fitusiran 10 (55%) Rebalancing therapy is the name for using RNA inhibitors (RNAi) that suppress mRNA synthesis, subsequently suppressing selected molecules. […]

Bleeding Disorders

August 2024 Quick Question: Hemophilia Treatment

Several hemophilia A or B treatments are in development or have been approved since 2021. Among these are the “rebalancing” preparations that suppress control proteins such as tissue factor pathway inhibitor (TFPI), antithrombin (AT), or activated protein C (APC). Rebalancing preparations are designed to compensate for the bleeding tendencies in FVIII or FIX deficiency without […]

Bleeding Disorders

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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.

Cheat Sheets from George

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