Safety Analysis of Clinical Laboratory Systems

A pilot medical information system is being implemented and currently is providing services for limited categories of patient data. In one year, physicians’ diagnoses for 500,000 office visits, 300,000 drug prescriptions for outpatients, one million clinical laboratory tests, and 60,000 multiphasic screening examinations are being stored in and retrieved from integrated, direct access, patient computer medical records.This medical information system is a part of a long-term research and development program. Its major objective is the development of a multifacility computer-based system which will support eventually the medical data requirements of a population of one million persons and one thousand physicians. The strategy employed provides for modular development. The central system, the computer-stored medical records which are therein maintained, and a satellite pilot medical data system in one medical facility are described.

Download Full-text

A Hexagonal (II) Phase Phospholipid Neutralization Assay for Lupus Anticoagulant Identification

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649671 ◽

1993 ◽

Vol 70 (05) ◽

pp. 787-793 ◽

Cited By ~ 77

Author(s):

Douglas A Triplett ◽

Linda K Barna ◽

Gail A Unger

Keyword(s):

Hemophilia A ◽

Clinical Laboratory ◽

Neutralization Assay ◽

Confirmatory Test ◽

Specific Factor ◽

Clinical Settings ◽

Drug Induced ◽

Variable Screening ◽

Routine Clinical Laboratory

SummaryLupus anticoagulants (LAs) are immunoglobulins (IgG, IgM, or both) which interfere with in vitro phospholipid (PL) dependent tests of coagulation (e.g. APTT, dilute PT, dilute Russell Viper Venom Time). These antibodies may be identified in a wide variety of clinical settings. With the exception of heparinized patient samples, the presence of LAs is often the most common cause of an unexplained APTT in a routine clinical laboratory. The diagnosis of LAs is difficult due to variable screening reagent sensitivity and intrinsic heterogeneity of LAs. Recently, Rauch and colleagues have shown human monoclonal hybridoma LAs were inhibited by hexagonal (II) phase PLs. In contrast, lamellar phase PLs had no effect. We have evaluated a new assay system, Staclot LA®, which utilizes a hexagonal (II) phase PL (egg phosphatidylethanolamine [EPE]) as a confirmatory test for LAs. Plasma samples from the following patient populations were studied: LA positive, heparinized, oral anticoagulated, hemophilia A and B, and specific factor inhibitors (factors V, VIII, IX). Unlike previous studies, the LA positive patients were a mixed population including: autoimmune diseases, drug-induced, and post-infection. Our findings confirm the specificity of hexagonal (II) phase PL neutralization of LAs.

Download Full-text

The Preparation and Evaluation of a Standardized Fibrin Plate for the Assessment of Fibrinolytic Activity

Thrombosis and Haemostasis ◽

10.1055/s-0038-1654135 ◽

1970 ◽

Vol 23 (02) ◽

pp. 202-210 ◽

Cited By ~ 13

Author(s):

R Bishop ◽

H Ekert ◽

G Gilchrist ◽

E Shanbrom ◽

L Fekete

Keyword(s):

Test Specimen ◽

Fibrinolytic Activity ◽

Clinical Laboratory ◽

Fibrin Clot ◽

Fibrinolytic Enzyme ◽

Agarose Gel ◽

Fibrin Plate ◽

Percent Concentration ◽

Human Plasminogen ◽

Preparation And Evaluation

SummaryA new fibrin plate technic for evaluating components of the fibrinolytic system has been developed. It provides quick, accurate, and easily interpreted results for the fibrinolytic profile. The standardized human plasminogen-free fibrin plates can be produced in bulk and stored for prolonged periods of time. A test specimen placed in a well punched in the buffered agarose gel diffuses into the agar and lyses the fibrin clot, forming a clear reaction zone. The zone diameter is directly proportional to the log of the percent concentration of available fibrinolytic enzyme in the specimen. The plates may be used to quantitate total plasminogen, and estimate available plasmin and active plasmin. A good correlation between results obtained using these fibrin plates and caseinolytic methods was found. Performance and interpretation of tests of fibrinolysis done on these new fibrin plates indicate that it may be the most sensitive technic available for clinical laboratory work.

Download Full-text