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van den Besselaar A, Tripodi A, Shiach C, Jespersen J, Poller L, Keown M, Chauhan N, Conard J, Dias D, Egberg N, Iriarte J, Kontopoulou-Griva I, Otridge B. European Concerted Action on Anticoagulation. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryA procedure for using citrated fresh plasmas for International Sensitivity Index (ISI) calibration of two types of whole blood point-of-care test (POCT) prothrombin time (PT) monitor systems has been assessed in a multicentre study.The CoaguChek Mini and TAS PT-NC systems gave higher ISI with whole blood samples than with fresh plasma calibrations. However, there was good agreement between whole blood and fresh plasma monitor system International Normalised Ratio (INR) and the reference INR of target samples.Reliable INR can therefore be obtained with both whole blood and plasma samples on these two POCT systems based on their respective ISI. With the CoaguChek Mini system, the plasma calibration ISI can also be used to derive reliable INR with whole blood PT results. This was not possible with the TAS PT-NC system.
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Poller L, Keown M, Chauhan N, van Den Besselaar AMHP, Tripodi A, Jespersen J, Shiach C, Horellou MH, Dias D, Egberg N, Iriarte JA, Kontopoulou-Griva I, Otridge B. European Concerted Action on Anticoagulation (ECAA): multicentre international sensitivity index calibration of two types of point-of-care prothrombin time monitor systems. Br J Haematol 2002; 116:844-50. [PMID: 11886390 DOI: 10.1046/j.0007-1048.2002.03361.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A multicentre modified World Health Organization (WHO)-type international sensitivity index (ISI) calibration has been performed at 10 European Concerted Action on Anticoagulation (ECAA) national laboratories using non-citrated whole-blood on two point-of-care test (POCT) prothrombin time (PT) monitor systems, CoaguChek Mini and TAS PT-NC, using single lots of test cards/strips. The relevant species (human and rabbit) WHO international reference preparations (IRPs) were tested with the manual PT technique on citrated plasma from the same blood donations. The ISI was calculated from the slope of the orthogonal regression line relating log PT (POCT) to log PT (IRP). The mean ISI of the CoaguChek Mini system was 1.75 and 1.13 with the prothrombin time non-citrated Thrombolytic Assessment System (TAS PT-NC). With the CoaguChek Mini system, seven out of 10 calibrations exceeded the current 3% WHO recommended limit for the coefficient of variation (CV) of the slope with conventional PT testing, whereas with the TAS PT-NC system, it was eight out of 10. All the POCT calibrations had a CV of the slope <5%. It is suggested that this level of precision be adopted as the limit of acceptability of calibration of these monitor systems. In these circumstances, the modified WHO-type ISI calibration appeared to be satisfactory for the POCT whole-blood monitors.
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Affiliation(s)
- L Poller
- ECAA Central Facility, School of Biological Sciences, The University of Manchester, Manchester, UK.
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Abstract
Mesenteric panniculitis is a rare disease of the bowel mesentery, characterized by tumor-like infiltration by chronic inflammatory cells, fat necrosis, and fibrosis. Reported cases cited clinical presentation ranging from abdominal pain to fever of unknown origin, the majority of which were idiopathic and associated with a benign prognosis. We report the case of a 43-yr-old male who presented with malaise, weight loss, microcytic anemia, and a high erythrocyte sedimentation rate. Radiographic and histological investigations revealed typical features of mesenteric panniculitis. Initial treatment with high-dose oral prednisolone led to rapid and complete resolution of symptomatology, radiographic, and laboratory anomalies. Within 6 months, the patient presented again with anemia, renal failure, and hypercalcemia. A diagnosis of IgA kappa chain myeloma was made. Despite chemotherapy and restoration of normocalcemia, he died from refractory pulmonary edema. This is the first report of a hematological malignancy initially presenting with features of mesenteric panniculitis culminating in an aggressive course and a fatal outcome.
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Affiliation(s)
- J Goh
- Department of Gastroenterology, Mater Misericordiae Hospital and University College, Dublin, Ireland
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Gleeson A, Owens D, Collins P, Johnson A, Tomkin GH, Sexton DM, Creedon G, Ledwith M, Griffin M, O’Meara N, Collins PB, Kilbane MT, Tuite AM, Shering SG, Smith DF, McDermott FWM, O’Higgins NJ, Smyth PPA, McKenna K, Thompson CJ, Kohler WM, O’Shea D, Alaghband-Zadeh J, Latham K, Carter G, Smyth PPA, Shering SG, Kilbane MT, McDermott EWM, Smith DF, O’Higgins NJ, Lovell SL, Leslie H, Doherty C, Hadden DR, McGeown MG, Kinsley BT, McKenna TJ, Byrne PM, Gallagher C, McKennal MJ, Li Voon Chong SW, Darby C, Freyne P, Cullen MJ, McKone E, Heffernan A, Darko DA, Kyrialcides E, O’Shea D, Burr R, Carter G, Armstrong VL, Ennis CN, Hunter SJ, Sheridan B, Atkinson AB, Bell PM, Giblin L, Griffin ME, Otridge B, O’Meara NM, Kinsley BT, Weinger K, Bajaj M, Levy CJ, Waters M, Simonson DC, Cox DJ, Jacobson AM, Armstrong VL, Ennis CN, Sheridan B, Atkinson AB, Bell PM, Traub AI, Creedon G, Sexton D, Griffin M, O’Meara N, Collins P, Wiggam MI, Bell PM, Sheridan B, Walmsley AE, Atkinson AB, Leary AC, Grealy G, Higgins TM, Buckley N, Barry DG, Murphy D, Ferriss JB, McConnell EM, Bell PM, Hadden DR, McCance R, Atkinson AB, Nikookam K, Suliman ME, Carroll M, Webster J, Wilson RM, Cullen DR, McAllister AS, McCance DR, Hadden DR, Bell PM, Leslie H, Sheridan B, Atkinson AB, Alavi Z, O’Hare JA, McAllister AS, Atkinson AB, McCance DR, Johnston GD, McKenna MJ, Freaney R. Irish endocrine society. Ir J Med Sci 1998. [DOI: 10.1007/bf02937356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kelly CP, Otridge B. Early experience with pre-deposit autotransfusion in elective orthopaedic surgery. Ir Med J 1992; 85:61-3. [PMID: 1628944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pre-deposit autotransfusion has been shown to be an effective method of providing blood for planned surgery. This study discusses preliminary experience with pre-deposit autotransfusion an alternative to homologous blood from those patients considered suitable donors according to established guidelines. In the first 24 weeks, 31 patients pre-donated 59 units of autologous blood for planned surgery. Twenty-nine patients (94%) underwent surgery and 24 (83%) of these did not require additional homologous blood. Two donations (3.6%) were complicated by minor reaction. All donors expressed satisfaction with the service. The authors conclude that in elective orthopaedic surgery pre-deposit autotransfusion is a safe and effective alternative to homologous transfusion.
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Affiliation(s)
- C P Kelly
- Cappagh Orthopaedic Hospital, Finglas, Dublin
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Abstract
Currently there is little information available about the efficacy of heparin during vascular surgery or of the effects of surgical trauma on heparin kinetics. This study was undertaken to evaluate the kinetics of heparin therapy during vascular surgery. Nine patients undergoing major vascular surgery (one carotid, one common iliac and seven aortic operations) were studied both preoperatively and intra-operatively, each patient acting as his own control. Following determination of control activated partial thromboplastin time (APTT) and plasma heparin levels, heparin (100 u/kg body weight) was administered intravenously. Heparin dosage ranged form 4500 units to 8600 units with a mean dose of 6500 units. Plasma heparin and APTT levels were then measured at 10 minute intervals for 1 hour and 20 minute intervals for a second hour. The mean pre-operative and intra-operative APTT levels at ten minutes attained maximal values of 6.6 +/- 3.7 and 8.8 +/- 1.7 times the control respectively. At the end of 2 hours the mean APTT remained greater than 2.5 times the control in both groups. Mean plasma heparin level was 0.83 +/- 0.04 units at 10 minutes and was almost identical in both groups. Heparin level was not a reliable indicator of anticoagulant effect as most patients achieved the same levels but had markedly differing APTT results. The results of this study suggest that excessive doses of heparin may be used in vascular surgery and that surgical trauma does not significantly alter sensitivity to heparin.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- N N Williams
- Department of Surgery, Royal College of Surgeons, Beaumont Hospital, Dublin, Ireland
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