American journal of clinical pathology
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Am. J. Clin. Pathol. · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialPoint-of-care testing for prothrombin time, but not activated partial thromboplastin time, correlates with laboratory methods in patients receiving aprotinin or epsilon-aminocaproic acid while undergoing cardiac surgery.
Point-of-care testing (POCT) of coagulation parameters can help optimize transfusion practice in cardiac surgery. Antifibrinolytic agents may interfere with the laboratory and/or POCT coagulation assays. This randomized controlled study compared coagulation parameters obtained from a whole blood POCT coagulation device with a typical laboratory instrument in cardiac surgery patients receiving aprotinin, epsilon-aminocaproic acid, or normal saline before undergoing cardiopulmonary bypass. ⋯ For PT, the POCT device compared favorably with the laboratory method. For aPTT, the POCT device did not compare well with the laboratory method. Treatment with antifibrinolytic agents does not interfere with determination of PT.
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The study examined a "percent correction" formula for evaluating mixing study results comparing a 1:1 mix with a new 4:1 mix of patient plasma with citrated normal plasma for a prolonged activated partial thromboplastin time (aPTT) and/or prothrombin time (PT). The study also examined 3 suggested definitions of correction for evaluating mixing study results for comparison. Applicability of percent correction for evaluating the aPTT 4:1 mix testing with and without incubation also was studied. ⋯ The percent correction of the aPTT 4:1 mix testing after incubation had better sensitivity and specificity that that of testing immediately. Nevertheless, these procedures were complementary to each other. The percent correction using the aPTT or PT 4:1 mix seemed to offer a simple, objective, and effective criterion for evaluating mixing study results.
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Am. J. Clin. Pathol. · Jan 2002
A systematic study of Epstein-Barr virus serologic assays following acute infection.
We determined the presence of IgG and IgM antibody to viral capsid antigen (VCA-IgG, VCA-IgM) and IgG antibody to the Epstein-Barr virus nuclear antigen (EBNA) by indirect immunofluorescence assay (IFA) and enzyme-linked immunosorbent assay (ELISA) during the acute illness and at 1, 2, 6, and 48 months in a prospective population-based case series of 95 persons with an acute illness serologically confirmed as Epstein-Barr virus infection. The acute illness was characterized by the presence of VCA-IgG and VCA-IgM (by ELISA) and by the absence of EBNA in most, but not all, patients. ⋯ The primary differences between the 2 serologic test methods were the increased persistence of VCA-IgM during follow-up by ELISA and the earlier detection of EBNA by IFA. Clinicians should consider the illness stage and the laboratory technique to appropriately interpret serologic test results in suspected cases of mononucleosis caused by the Epstein-Barr virus.