Portraits of the lucky individuals who posed with me at the Greater New Orleans Coagulation Conference 2010, hosted by Louisiana Coagulation Laboratory, Inc, in February are now online.
For each photo taken, Precision BioLogic, sponsor of The Fritsma Factor, made a donation to Rebuilding Together New Orleans. The result–enough to purchase 10 interior doors, nearly 30 gallons of interior primer, or more than 250 square feet of bamboo flooring to rehabilitate homes damaged by Hurricane Katrina.
Here’s a note from Betsy Vokac, Marketing Manager, Diagnostic Laboratories at Blood Center of Wisconsin .
Hi George,
I was just chatting with Bob Montgomery and he mentioned that he’s going to Kenya in June to help establish a coagulation laboratory. He is specifically looking for a person or institution who might be willing to donate a retired fibrometer.
I thought I’d also ask if you can think of any colleagues who might be able to respond to this request. Is this something I could post on The Fritsma Factor?
With regards from Wisconsin,
Betsy Vokac
Hi, Betsy. I am happy to post your request and wish Dr. Montgomery well on his trip. I suggest he get in touch with Carol or Ed Bos at Worldwide Laboratory Improvement, Inc, Kalamazoo, MI. Ed and Carol solicit surplus or old equipment from distributors and other sources, refurbish it, and make it available to labs in developing countries. They are likely to have fibrometers available. Geo.
I work in a public not-for-profit hospital with a large neonatal ICU population. We instruct the staff in NICU to use the least volume of blood possible for coagulation tests. We have always used the siliconized glass BD Vacutainer® “baby” 1.7 ml draw tubes requiring at least 1 mL of blood. We have been told we have to use the plastic tubes now. What do you consider the minimum volume to place in the blue top tube? Remember some of these babies only weigh 1-2 lbs. Thanks.
Emily Oakley, MT (ASCP) SH
Special Hematology/Special Coagulation
Medical Center Laboratory, Jackson, TN
I mentioned in a January 8, 2008 post that Diagnostica Stago® offers a global hemostasis assay, the Calibrated Automated Thrombogram (CAT) for research use. The CAT is performed using Thrombinoscope™ software (Thrombinoscope BV) on the Thrombinograph®, a 96-well plate fluorimeter available from Thermo Scientific. The method uses a thrombin calibrator that corrects for inner filter effect, plasma color variability, substrate depletion and instrument differences.
The CAT records the concentration of thrombin in clotting plasma and is a general physiologic function test of the hemostatic system. The CAT is used to…
Measure any genetic or acquired thrombotic disorder such as antithrombin deficiency.
Support the development of antithrombotic drugs such as antiplatelet drugs and direct thrombin inhibitors.
Monitor the treatment of hemophilia using factor VIII or factor VIIa.
Monitor the treatment of thrombosis using oral anticoagulants, heparin, antiplatelet drugs or antithrombotic combinations.
I had the pleasure of meeting and speaking with Paul Riley, PhD, Manager of Research Use Products, Diagnostica Stago, Inc., New Jersey. Paul said that Stago is now partnering with the advanced research and development company BioCytex to market ready to use flow cytometric assays for hemostasis diagnosis. They can now identify P2Y12 occupancy via the downstream marker VASP , platelet glycoprotein IIb/IIIa occupancy, platelet PAIg, and RBC paroxysmal nocturnal hemoglobinuria (PNH) markers CD 55 and CD 59, among others. This is an exciting new venture for Stago and helps open the door to more extensive platelet activation analysis. For further information, I have attached the Biocytex catalog.
Here is a summary of our February Quick Question, “How do you examine coagulation specimens for clots?”
a. We run an applicator stick through each specimen before centrifuging: 10 (17%)
b. We run an applicator stick through specimens from certain units in our medical center: 2 (3%)
c. We examine the specimen visually before and after centrifuging: 14 (24%)
d. We place the centrifuged specimen on our instrument and respond to implausible results: 33 (56%)
This QQ generated seven comments. Some are concerned that using applicator sticks before spinning activates platelets and the coagulation system. Others doubted the effectiveness of visual inspection, particularly as many institutions place at least two labels on the tube, blocking any view of the specimen. Still others indicated their concern that we report plausible results from partially clotted specimens, thereby missing potential pathological results. Bill Chamlee of the Cleveland VA suggests checking for clots after the specimen has been centrifuged and assayed, then canceling results of those that are clotted. While laborious, this may be the most effective approach. It seems this would be a fertile issue for a clinical researcher.
From Bob Dahms, Coagulation Technical Specialist, Long Beach Memorial (first-time user):
I am looking for literature to contraindicate performing factor VIII inhibitor screening and Bethesda titers. I restrict orders for both unless the patient has a factor VIII <20%. Also, post-treatment factor VIII levels of 40-50% have questionable Bethesda titer interpretation. Screening a 9:1 mix at 37 degrees for two hours is also ineffective. There must be some gate keeper recommendations for restricting the application of Bethesda titers. They are time consuming and technical. When are they not appropriate?
A second area of interest is factor IX inhibitor screening. Most reports seem to suggest either 15 minutes incubation at 37 degrees or immediate testing. Any guidance on this issue? Read more »
Events | GeorgeFritsma | 
March 29, 2010 10:08 am | 
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