A message from “ETM:”
Hi George, what is the definition of global hemostasis assays and what tests are included in this umbrella term? Thanks.
Hello, and thank you for your question. Global hemostasis assays are assays designed to assess the risk of bleeding, thrombosis, fibrinolysis and response to antithrombotics in a single assay, often performed on whole blood. The assays are affected by coagulation and platelet changes or abnormalities.
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Our April, 2010 Quick Question was “Do you collect a discard tube prior to collecting a tube for coagulation testing?”
Answers:
a. Never: 14 (34%)
b. Always: 14 (34%)
c. Only for special coagulation testing: 13 (32%)
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If you’d rather see a brief summary than read an entire post, please see our Cheat Sheet for March, 2010. This will also be distributed to you via e-mail on May 4.
Here’s a message from Michelle Brown, MS, MLS, faculty at the University of Alabama at Birmingham (UAB) School of Health Professions. Michelle teaches Immunohematology and coordinates the clinical rotations in the Clinical Laboratory Science program that I retired from in 2007. She was Margaret Fritsma’s graduate student a few years ago and now occupies Margaret’s former faculty position. Michelle is busy raising a family and is active in the local Blood Bank society. I enjoy hearing from her.
George, I have a graduate student, Destiny, who is interested in researching thrombosis in athletes. Destiny was a high school and college athlete. She said she had a clot in her leg when she was 16. She obtained her medical records, we reviewed them and found out she didn’t have a clot, but she had MRSA with associated complications. Thrombosis is not my area of expertise, but it is definitely an area of high interest and an area in which I would like to grow. Are there any hot topics related to thrombosis in athletes? Much of the literature I have come across in my brief searches are case studies with short discussions of laboratory diagnosis. I would truly appreciate any thoughts you might share on thrombosis in athletes.
Thanks for your question, Michelle. I’m posting this for my more athletic Fritsma Factor participants who may have some direct insight. I speculate that thrombosis in athletes often arises directly from minor injuries or from periods of immobilization secondary to injuries. Do any of you coag-lovin’ jocks have something to share? Geo.
An article in the current Archives of Internal Medicine identifies the sulfonamide antibiotic cotrimoxazole (Bactrim® and several generics) as conferring a 3.84 odds ratio of upper gastrointestinal bleeding when co-prescribed with warfarin in patients >66. Likewise ciprofloxacin (Ciprol®) co-therapy generated an odds ratio of 1.94, also significant. These antibiotics are primarily used for urinary tract infection and may reduce vitamin K-producing intestinal flora and may also compete with warfarin metabolism through the cytochrome P450 enzyme 2C9. Co-therapy with amoxicillin, ampicillin, nitrofurantoin or norfloxacin did not significantly raise patient bleeding risk. Fischer HD, Juurlink DN, Mamdani MM, Kopp A, Laupacis A. Hemorrhage during warfarin therapy associated with cotrimoxazole and other urinary tract anti-infective agents. Arch Intern Med 2010; 170: 617–21.
Here is a message from subscriber Dkaguni:
“Historical ranges are often used to determine the range for coagulation assays. Are there general guidelines as to how large these ranges can be?”
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Double congratulations to the leadership and staff at Precision BioLogic, Inc., my sponsor, for once again achieving Best Workplaces in Canada status, this time ranked number eight in the country. Please follow the link to the Precision site for complete details. Meanwhile, please celebrate PBI’s success with me! Geo.
From Patricia Doleski, Kaleida Health:
When changing lots of PTT reagent one of the lot change studies we perform is the factor VIII sensitivity. What is the minimum amount of factor VIII that is generally expected from a PTT reagent? Read more »
Global Hemostasis Assays | GeorgeFritsma | 
April 28, 2010 7:21 am | 
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