Trinity Bio-Tech of Dublin, Ireland announced Thursday, March 11 the sale of their coagulation business, including manufacture of their Destiny Max coagulometer to Diagnostica Stago, Incorporated of Asnieres, France.
General | GeorgeFritsma | 
March 13, 2010 4:28 pm | 
Comments (0)
This arrived Wednesday from Mr. Peter Clement, MLS Student at Brigham Young University in Provo, Utah:
I am currently studying to become a Medical Laboratory Scientist. My professor is Dr. Shauna Anderson at BYU. I asked today if she had ever visited a website called Fritsma Factor, to which she replied yes and she added that she knows you. I have one question but before I just wanted to say that I have enjoyed using your site through three grueling weeks of coag that I’m almost done experiencing this Friday.
My question for you is whether or not there is a way to distinguish between high molecular weight kininogen (HMWK, Fitzgerald) factor and factor XII deficiencies without using assays? Apparently, according to old school methods you could differentiate prekallikrein (PK, Fletcher) deficiency by incubating for a longer period with kaolin and you can differentiate factor XI deficiency because it’s associated with bleeding tendency. However, all my research indicates that assays and perhaps family history are the only ways to differentiate HMWK from XII deficiency. Also, have they found anything that indicates why people with factor XII deficiency do not experience bleeding tendency?
Hi George,
I have a 33 yo HIV positive non-compliant female patient with chronic kidney disease. Labs:
PT: 13.4 (11.7-14.2)
PTT: 47 (23-33)
FIB: 300mg/dL
D-DIMER: 1.61 FEU
Where do I go from here?
Richard Larsen, US Army
Mixing Studies | GeorgeFritsma | March 9, 2010 6:22 am | Comments (5)
If you can assist Dr. Pena, please respond via the “comments” section below. This was sent through Dr. Marisa Marques, University of Alabama at Birmingham Hospital:
Dear Marisa, how are you?
I work for Norton Healthcare in Louisville, KY. We are trying to set up our assay for anti-Xa for low molecular weight heparin. We are having a hard time finding another laboratory to do the initial correlation. We use a BCX instrument. We use a straight curve for the anti-Xa for unfractionated
heparin and use exogenous antithrombin in the test system. My questions are:
1. Do you know of any lab that uses a similar system?
2. Is there an alternative for the correlation, if we do not find another
(reference) lab?
The best for you and your lovely family. Elpidio
Elpidio Pena, MD
Medical Director Transfusion Services
Norton Healthcare
From Bill Chamlee at the Cleveland VA:
Hi George,
I stumbled onto your site while researching the new lower potency heparin/therapeutic range issue. I was interested in your quick question about checking for clots. I don’t do any of the four choices you list. I use two applicator sticks to check for clots after centrifuging and running first. The sticks can act as an activator and my experience is that the PTT is usually shorter after rimming for clots, more noticeably of course in abnormal and therapeutic specimens. And I still don’t understand how you can identify a clotted specimen by looking at the test results. Sure, sometimes the low PTT is a dead giveaway. But not always–the normal looking PTT could really be high. And what if it’s only a PT-INR? I know CAP lists that as an acceptable choice, but I don’t know why. With my method, I have seen plenty of clotted specimens with perfectly “plausible” results. But are they accurate results? I reject them. So does CAP imply clotted specimens are OK if they give plausible results?
Read more »
Specimen Collection | GeorgeFritsma | March 3, 2010 2:51 pm | Comments (4)
I’m a registrar in an ICU at Menofyia University, Menofyia, Egypt. We have been thinking about using the new drug, Fondaparinux. Could you please give me more details about the drug, when to monitor its efficacy (all patients or high risk only?) and how do you use the anti-factor Xa assay; i. e. the kits and the frequency of monitoring? is it a daily blood sample in the case of the prophylactic dose (2.5 mg)? Where could I find these kits? could you give me the address of any specialized company in coagulation monitoring. Hagar
Anticoagulant Therapy | GeorgeFritsma | 2:18 pm | Comments (2)
Subscribe