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interpretation of coagulation test

A Magnette, M Chatelain, B Chatelain, H Ten Cate, F Mullier
Ensuring quality has become a daily requirement in laboratories. In haemostasis, even more than in other disciplines of biology, quality is determined by a pre-analytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until time of analysis. This step, based on a variety of manual activities, is the most vulnerable part of the total testing process and is a major component of the reliability and validity of results in haemostasis and constitutes the most important source of erroneous or un-interpretable results...
2016: Thrombosis Journal
Taejong Song, Dong Hee Lee, Hwa Cheung Kim, Seok Ju Seong
OBJECTIVE: To present our experience with laparoscopic tube-preserving surgery for ectopic tubal pregnancy and evaluate its feasibility and efficacy. METHODS: This was a prospective study of 57 consecutive patients with ectopic tubal pregnancies undergoing laparoscopic tube-preserving procedures including salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking. The outcome measures were treatment success rates and homolateral patency rates...
November 2016: Obstetrics & Gynecology Science
Lucia Mirabella, Antonella Cotoia, Giusj Colacicco, Livio Tullo, Potito Salatto, Giuseppina Mollica, Karim Mariano, Michele Dambrosio, Gilda Cinnella
BACKGROUND: Most data in the literature report reduced coagulation activities in the first few days of life with respect to adults and the effects of these differences must be considered when diagnosing and treating haemostatic disorders. Management of pediatric population is further complicated by the lack of age-related reference values and by unreliability of hemostatic tests currently used while an accurate interpretation of results are required to reduce the cases of inappropriate investigation...
November 18, 2016: Minerva Anestesiologica
Jung-Min Park, Kyung-Hwa Chang, Kwang-Hoon Park, Seong-Jin Choi, Kyuhong Lee, Jin-Yong Lee, Masahiko Satoh, Seong-Yu Song, Moo-Yeol Lee
The generation and collection of cigarette smoke (CS) is a prerequisite for any toxicology study on smoking, especially an in vitro CS exposure study. In this study, the effects on blood and vascular function were tested with two widely used CS preparations to compare the biological effects of CS with respect to the CS preparation used. CS was prepared in the form of total particulate matter (TPM), which is CS trapped in a Cambridge filter pad, and cigarette smoke extract (CSE), which is CS trapped in phosphate-buffered saline...
October 2016: Toxicological Research
Andrea Morotti, Joshua N Goldstein
Direct oral anticoagulants (DOAC) are an attractive therapeutic option for anticoagulant treatment in the setting of venous thromboembolism or non-valvular atrial fibrillation. These drugs overall appear to have a lower risk of life-threatening hemorrhage than the vitamin K antagonists. In addition, they demonstrate more predictable and stable pharmacokinetics. Measurement of the degree of anticoagulation is desirable in patients with DOAC-associated hemorrhage, but commonly available coagulation assays show poor sensitivity for degree of DOAC effect...
November 2016: Current Treatment Options in Neurology
Fazoil I Ataullakhanov, Ekaterina M Koltsova, Anna N Balandina, Ilya I Serebriyskiy, Tatiana A Vuimo, Mikhail A Panteleev
Pregnancy is associated with a significant procoagulant shift in the hemostatic system balance as well as other metabolic changes. Pregnancy can thereby provoke manifestation of otherwise dormant disorders of hemostasis (e.g., thrombophilia), or even cause new, pregnancy-specific disorders (e.g., HELLP syndrome). Application and interpretation of laboratory assays of hemostasis in pregnancy is particularly challenging, because normal physiological ranges are no longer applicable, and because the most dangerous and complex changes are not detected by classic routine coagulation/platelet assays...
October 2016: Seminars in Thrombosis and Hemostasis
Fatma Demet Arslan, Muhittin Serdar, Elif Merve Ari, Mustafa Onur Oztan, Sureyya Hikmet Kozcu, Huseyin Tarhan, Ozgur Cakmak, Merve Zeytinli, Hamit Yasar Ellidag
BACKGROUND: In order to apply the right treatment for hemostatic disorders in pediatric patients, laboratory data should be interpreted with age-appropriate reference ranges. OBJECTIVES: The purpose of this study was to determining age-dependent reference range values for prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen tests, and D-dimer tests. MATERIALS AND METHODS: A total of 320 volunteers were included in the study with the following ages: 1 month - 1 year (n = 52), 2 - 5 years (n = 50), 6 - 10 years (n = 48), 11 - 17 years (n = 38), and 18 - 65 years (n = 132)...
June 2016: Iranian Journal of Pediatrics
Shawn Collins, Carolyn MacIntyre, Ian Hewer
The coagulation cascade is a dynamic process dependent on many factors. It involves interaction between primary hemostasis, platelet clot formation, secondary hemostasis, thrombin generation, and fibrinolysis. The assessment of this process is particularly important in the surgical patient to properly manage hemostatic issues. Traditionally, coagulation tests used to guide transfusion management have included platelet count, activated partial thromboplastin time, prothrombin time, international normalized ratio, and activated clotting time, among others...
April 2016: AANA Journal
Wan Hui Wong, Christina Yc Yip, Christina Ll Sum, Chuen Wen Tan, Lai Heng Lee, Eng Soo Yap, Ponnudurai Kuperan, Wen Chang Ting, Heng Joo Ng
INTRODUCTION: Direct oral anticoagulants (DOACs) are establishing themselves as principle choices for the treatment of a variety of thrombotic disorders. DOACs are also known to affect common coagulation tests which are routinely performed for patients in clinical practice. An understanding of their varied effects is crucial for the appropriate ordering of coagulation tests and their interpretation. MATERIALS AND METHODS: Laboratories in public and private healthcare institutions and commercial sectors were surveyed on coagulation tests offered and their methods...
March 2016: Annals of the Academy of Medicine, Singapore
Franz Ratzinger, Mona Lang, Sabine Belik, Petra Jilma-Stohlawetz, Klaus G Schmetterer, Helmuth Haslacher, Thomas Perkmann, Peter Quehenberger
Non-vitamin K antagonist oral anticoagulants (NOAC), including rivaroxaban, apixaban or dabigatran, regularly show relevant effects on coagulation tests, making the interpretation of results difficult. The aim of this study was to evaluate possible interferences of NOACs in trough level concentrations in lupus anticoagulant (LA) testing. Citrate plasma specimens of 30 healthy volunteers were spiked with rivaroxaban, apixaban or dabigatran in four plasma concentration levels at or below trough NOAC levels. The NOAC concentration was measured using dedicated surrogate concentration tests and a stepwise diagnostic procedure for LA-testing was applied using screening, mixing and confirmatory testing...
August 1, 2016: Thrombosis and Haemostasis
Q Wang, B Dong, J Firrman, W Wu, S Roberts, A R Moore, L S Liu, M P S Chin, Y Diao, J Kost, W Xiao
The canine is the most important large animal model for testing novel hemophilia A (HA) treatment. It is often necessary to use canine factor VIII (cFIII) gene or protein for the evaluation of HA treatment in the canine model. However, different biological properties between cFVIII and human FVIII (hFVIII) indicated that the development of novel HA treatment may require careful characterization of non-human FVIII. To investigate whether the data obtained using cFVIII can translate to HA treatment in human, we analyzed the differential biological properties of canine heavy chain (cHC) and light chain (cLC) by comparing with human heavy chain (hHC) and light chain (hLC)...
July 2016: Gene Therapy
M G Manca, J Serdino, G Gaspa, P Urgeghe, I Ibba, M Contu, P Fresi, N P P Macciotta
Milk composition and its technological properties are traits of interest for the dairy sheep industry because almost all milk produced is processed into cheese. However, several variables define milk technological properties and a complex correlation pattern exists among them. In the present work, we measured milk composition, coagulation properties, and individual cheese yields in a sample of 991 Sarda breed ewes in 47 flocks. The work aimed to study the correlation pattern among measured variables and to obtain new synthetic indicators of milk composition and cheese-making properties...
June 2016: Journal of Dairy Science
Lindsay Tomlinson, Lila Ramaiah, Niraj K Tripathi, Valerie G Barlow, Allison Vitsky, Florence M Poitout-Belissent, Denise I Bounous, Daniela Ennulat
The Society of Toxicologic Pathology formed a working group in collaboration with the American Society for Veterinary Clinical Pathology to provide recommendations for the appropriate inclusion of clinical pathology evaluation in recovery arms of nonclinical toxicity studies but not on when to perform recovery studies. Evaluation of the recovery of clinical pathology findings is not required routinely but provides useful information on risk assessment in nonclinical toxicity studies and is recommended when the ability of the organ to recover is uncertain...
February 2016: Toxicologic Pathology
A Olaiya, B Lurie, B Watt, L McDonald, M Greaves, H G Watson
UNLABELLED: Essentials Ignorance of direct oral anticoagulants' effects on coagulation tests may be a safety issue. An electronic questionnaire was sent to prescribers in NHS Grampian with 143 respondents. We found widespread evidence of inappropriate interpretation of the clinical scenarios given. The study suggests potential for patient harm due to lack of knowledge and education is required. SUMMARY: Background Lack of awareness of the nature of the direct oral anticoagulants (DOACs) combined with the poor correlation between routine coagulation test prolongation and the activity of these drugs represents a potential for patient harm...
May 2016: Journal of Thrombosis and Haemostasis: JTH
R C Gosselin, D M Adcock
The introduction of direct oral anticoagulant (DOAC) therapy into clinical use in the past 5 years has had significant impact on the clinical laboratory. Clinicians' desire to determine plasma drug presence or measure drug concentration, and more recent observations regarding the limitations and utility of coagulation testing in the setting of DOAC treatment, suggest that early published recommendations regarding laboratory testing should be reassessed. These initial recommendations, furthermore, were often based on drug-spiked plasma studies, rather than samples from patients receiving DOAC therapy...
May 2016: Journal of Thrombosis and Haemostasis: JTH
Julie Jaffray, Guy Young, Richard H Ko
The neonatal hemostatic system is continuously developing with rapidly changing concentrations of many coagulation proteins. Thus, determining the etiology of bleeding in a newborn has additional challenges beyond those seen in older children or adults. Bleeding can be seen in both well and sick newborns due to congenital causes, such as hemophilia or von Willebrand disease, and acquired causes, such as liver failure or disseminated intravascular coagulation. Traditional coagulation testing should be interpreted with caution and with the help of a hematologist, if possible, due to the greatly different normal ranges between neonates as compared with older children and adults...
February 2016: Seminars in Fetal & Neonatal Medicine
Vishal Venkat Raman, Ramanathan Kasivisvanathan, Pradeep R Madhivathanan
Viscoelastic tests provide a global and dynamic assessment of the coagulation system and thus are becoming increasingly relied upon in the perioperative period. Many clinicians are unfamiliar with viscoelastic testing, so this article provides an overview of their use and interpretation in the management of perioperative bleeding.
December 2015: British Journal of Hospital Medicine
Sayed E Wahezi, Andrew Lederman, Jeffrey Algra, Soo Yeon Kim, Rani Sellars
BACKGROUND: Case reports of catastrophic neurological sequelae during ESIs have questioned the safety of this procedure. A proposed mechanism is particulate steroid embolization resulting in neuralischemia. Previous reports have described steroid clumping in common epidural injection mixtures. We demonstrate that physiologic medium can also modify aggregation. OBJECTIVE: To inspect and compare aggregative properties of steroid preparations with and without human serum...
November 2015: Pain Physician
Jonathan Douxfils, Bernard Chatelain, Christian Chatelain, Jean-Michel Dogné, François Mullier
Assessment of plasma concentration/effect of edoxaban may be useful in some situations. Also, clinicians need to know how routine coagulation assays are influenced. It was our aim to determine coagulation tests useful for the assessment of edoxaban's pharmacodynamics and provide recommendations for the interpretation of haemostasis diagnostic tests. Edoxaban was spiked at concentrations ranging from 0 to 1,000 ng/ml in platelet-poor plasma which covers the on-therapy range (from ± 25 ng/ml at Ctrough to ± 170 ng/ml at Cmax)...
January 2016: Thrombosis and Haemostasis
Corinna Lau, Ole Kristoffer Olstad, Marit Holden, Ståle Nygård, Hilde Fure, Knut Tore Lappegård, Ole-Lars Brekke, Terje Espevik, Eivind Hovig, Tom Eirik Mollnes
Non-sterile pathogen-induced sepsis and sterile inflammation like in trauma or ischemia-reperfusion injury may both coincide with the life threatening systemic inflammatory response syndrome and multi-organ failure. Consequently, there is an urgent need for specific biomarkers in order to distinguish sepsis from sterile conditions. The overall aim of this study was to uncover putative sepsis biomarkers and biomarker pathways, as well as to test the efficacy of combined inhibition of innate immunity key players complement and Toll-like receptor co-receptor CD14 as a possible therapeutic regimen for sepsis...
September 2015: Genomics Data
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