“Smart” WPC reflex testing enables optimal use of the WPC channel in the detection of malignant blood samples using Sysmex XN‐9100

Background: Diagnosis of chronic hepatitis C virus (HCV) infection typically involves collection of venous blood samples prior to serological investigation of an antibody response followed by a confirmatory viral load or antigen test to verify active HCV infection. This conventional pathway poses logistical challenges for the implementation of reflex testing, whereby the confirmatory test is performed on the same sample used for serological investigation. Dried blood spot (DBS) testing, in which capillary blood is deposited on filter paper, is a less invasive alternative that can enable reflex testing without the need for venepuncture, centrifugation and freezing of samples. Methods: This systematic review aims to assess the diagnostic accuracy of DBS compared with venous blood samples for diagnosis of chronic HCV infection. Observational studies which compare diagnostic tests using DBS with those using serum, plasma or whole blood in patients with chronic or resolved HCV infection will be included. Electronic searches will be conducted in PubMed, Embase, Scopus, Web of Science, Lilacs and the Cochrane library. Citation screening, data extraction and quality appraisal of included studies will be performed in duplicate using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A meta-analysis will be conducted to derive pooled estimates of sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, and diagnostic odds ratios. Sensitivity analyses and meta-regression will also be performed. Quality of the evidence will be evaluated using the GRADE criteria. Discussion: Identifying and linking people with currently undiagnosed chronic HCV infection to care is pivotal to attaining global viral hepatitis elimination targets. The use of DBS could simplify diagnostic testing strategies by integrating reflex testing into the care pathway and reducing drop-off along the cascade of care. Registration: PROSPERO, CRD42020205204. Registered 19th September 2020.

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Stability of antioxidant vitamins in whole human blood during overnight storage at 4°C and frozen storage up to 6 months

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000485 ◽

2018 ◽

Vol 88 (3-4) ◽

pp. 151-157 ◽

Cited By ~ 3

Author(s):

Scott W. Leonard ◽

Gerd Bobe ◽

Maret G. Traber

Keyword(s):

Ascorbic Acid ◽

Whole Blood ◽

Healthy Subjects ◽

Frozen Storage ◽

Blood Collection ◽

Plasma Samples ◽

Optimal Conditions ◽

Plasma Ascorbic Acid ◽

Blood Samples ◽

Sample Handling

Abstract. To determine optimal conditions for blood collection during clinical trials, where sample handling logistics might preclude prompt separation of erythrocytes from plasma, healthy subjects (n=8, 6 M/2F) were recruited and non-fasting blood samples were collected into tubes containing different anticoagulants (ethylenediaminetetra-acetic acid (EDTA), Li-heparin or Na-heparin). We hypothesized that heparin, but not EDTA, would effectively protect plasma tocopherols, ascorbic acid, and vitamin E catabolites (α- and γ-CEHC) from oxidative damage. To test this hypothesis, one set of tubes was processed immediately and plasma samples were stored at −80°C, while the other set was stored at 4°C and processed the following morning (~30 hours) and analyzed, or the samples were analyzed after 6 months of storage. Plasma ascorbic acid, as measured using HPLC with electrochemical detection (LC-ECD) decreased by 75% with overnight storage using EDTA as an anticoagulant, but was unchanged when heparin was used. Neither time prior to processing, nor anticoagulant, had any significant effects upon plasma α- or γ-tocopherols or α- or γ-CEHC concentrations. α- and γ-tocopherol concentrations remained unchanged after 6 months of storage at −80°C, when measured using either LC-ECD or LC/mass spectrometry. Thus, refrigeration of whole blood at 4°C overnight does not change plasma α- or γ-tocopherol concentrations or their catabolites. Ascorbic acid is unstable in whole blood when EDTA is used as an anticoagulant, but when whole blood is collected with heparin, it can be stored overnight and subsequently processed.

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Steadiness/stability of antiepileptic drugs in serum, plasma and whole-blood samples under various storage methods

Neuropediatrics ◽

10.1055/s-0030-1265593 ◽

2010 ◽

Vol 41 (02) ◽

Author(s):

N Shazi ◽

A Böss ◽

HJ Merkel ◽

F Scharbert ◽

D Hannak ◽

...

Keyword(s):

Antiepileptic Drugs ◽

Whole Blood ◽

Blood Samples ◽

Storage Methods ◽

Whole Blood Samples

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Assessment of the Validity of the INR System for Patients with Liver Impairment

Thrombosis and Haemostasis ◽

10.1055/s-0038-1642513 ◽

1994 ◽

Vol 71 (06) ◽

pp. 727-730 ◽

Cited By ~ 85

Author(s):

M J Kovacs ◽

A Wong ◽

K MacKinnon ◽

K Weir ◽

M Keeney ◽

...

Keyword(s):

Oral Anticoagulants ◽

Control Population ◽

Blood Samples ◽

Liver Impairment ◽

Study Population ◽

Level Of Significance

SummaryThe INR system was developed to standardize PT reporting in patients on oral anticoagulants. We prospectively collected blood samples from 29 patients with liver impairment (INR 1.5-3.5). Control patients were on warfarin (n = 31). PT’s were measured on an ACL-300 with three thromboplastin reagents. INR’s were calculated using instrument specific ISI’s. Other tests performed were FDP’s, fibrinogen, aPTT, factors II, V, VII and X. The INR’s for each patient in the study population using the three thromboplastin reagents were significantly different (p = 0.0001). Those for the control population were not (p = 0.0658). Fibrinogen, factors V, II and X were different at the 5% level of significance between the populations. FDP’s were detected in 17 study subjects. The INR system is not valid for comparison of patients with liver impairment because different reagents do not give the same INR for the same sample. It is, however, no less valid than the use of PT with different thromboplastin reagents. Further study is recommended.

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1-Desamino-8-D-Arginine Vasopressin (DDAVP) Infusion in Type IIB von Willebrand’s Disease: Shortening of Bleeding Time and Induction of a Variable Pseudothrombocytopenia

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647265 ◽

1990 ◽

Vol 64 (01) ◽

pp. 117-120 ◽

Cited By ~ 22

Author(s):

Alessandra Casonato ◽

M Teresa Sartori ◽

Luigi de Marco ◽

Antonio Girolami

Keyword(s):

Monoclonal Antibody ◽

Platelet Count ◽

Arginine Vasopressin ◽

Calcium Concentration ◽

Sodium Citrate ◽

Bleeding Time ◽

Blood Collection ◽

Von Willebrand's Disease ◽

Blood Samples ◽

Von Willebrand’S Disease

SummaryWe have investigated the effects of 1-desamino-8-D-arginine vasopressin (DDAVP) infusion on platelet count and bleeding time in 4 patients with type IIB von Willebrand’s disease (vWd). Three of four patients showed a normalization of the bleeding time within 1 h after the infusion, while bleeding time was not modified in the fourth. In accordance with the literature, thrombocytopenia was observed after DDAVP infusion, but this thrombocytopenia was due to the anticoagulants used for blood collection. In two patients (F. I., G. F.) no thrombocytopenia was observed when platelets were counted by fingerstick method but there was a 20% platelet decrease in blood samples collected in sodium citrate and a 50% decrease in samples collected in EDTA. Dramatic falls in platelet counts (70–95%) were observed in the additional two patients (C. A., D.Z.) after DDAVP infusion, when both sodium citrate or EDTA were used as anticoagulants. In the latter two patients there was also a 50% decrease in platelet count when the fingerstick method was used. The decrease in the patient’s platelet count in EDTA samples after DDAVP infusion could be prevented, in part, by the previous additions of an anti GPIb monoclonal antibody and an anti GPIIb-IIIa monoclonal antibody.Thus, the thrombocytopenia observed in the four IIB vWd patients studied after DDAVP infusion seems to be, at least partially, a pseudothrombocytopenia depending on the calcium concentration in the blood samples and the availability of GPIb and GPIIb-IIIa receptors. These findings and the normalization of the bleeding time observed in three of the four patients has led us to reconsider the possible use of DDAVP in the treatment of our IIB vWd patients.

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Platelet Mobilization Induced by PAF and Its Role in the Thrombocytosis Triggered by Adrenaline in Rats

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647127 ◽

1989 ◽

Vol 62 (04) ◽

pp. 1107-1111 ◽

Cited By ~ 5

Author(s):

Hugo C Castro-Faria-Neto ◽

Patricia T Bozza ◽

Marco A Martins ◽

Paulo M F L Dias ◽

Patricia M R Silva ◽

...

Keyword(s):

Receptor Antagonists ◽

Blood Samples ◽

Platelet Counts ◽

Platelet Number ◽

Edta Solution ◽

Web 2086 ◽

Dependent Mechanism

SummaryThe injection of PAP (6 μg/kg, i. v.) induced, in rats, haemoconcentration accompanied by an increase in the platelet number, as attested by the counts of platelets in blood samples diluted in formalin-free EDTA solution. This increase was significant at 15 min, peaked from 1 to 4 h and returned to basal levels 24 h after the lipid administration. The release of platelets induced by PAP was inhibited dose-dependently by specific PAP receptor antagonists such as WEB 2086 (0.5-2 mg/kg), BN 52021 and 48740 RP (5-25 mg/kg). Furthermore, platelet mobilization was clearly impaired in splenectomized animals stimulated by PAP, whereas thrombocytopenia and haemoconcentration by the same stimulus were intact. It was also noted that a second injection of PAP, 24 h after the initial stimulation with the lipid, failed to induce an increase in platelet counts, indicating autodesensitization. Desensitization to PAP or pretreatment with PAP antagonists clearly prevented the increase in the platelet counts after stimulation by adrenaline (15 μg/kg). These findings suggest that, in rats, PAP can induce release of platelets by a spleen-dependent mechanism and that this lipid may be relevant to the thrombocytosis triggered by adrenaline.

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Markers of Hemostatic Activation in Affected Coronary Arteries during Angioplasty

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648940 ◽

1994 ◽

Vol 72 (05) ◽

pp. 672-675 ◽

Cited By ~ 14

Author(s):

Nicolas W Shammas ◽

Michael J Cunningham ◽

Richard M Pomearntz ◽

Charles W Francis

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Venous Blood ◽

Balloon Inflation ◽

Blood Samples ◽

Hemostatic System ◽

Significant Difference ◽

Hemostatic Markers ◽

Artery Disease ◽

High Doses

SummaryTo characterize the extent of early activation of the hemostatic system following angioplasty, we obtained blood samples from the involved coronary artery of 11 stable angina patients during the procedure and measured sensitive markers of thrombin formation (fibrino-peptide A, prothrombin fragment 1.2, and soluble fibrin) and of platelet activation ((3-thromboglobulin). Levels of hemostatic markers in venous blood obtained from 14 young individuals with low pretest probability for coronary artery disease were not significantly different from levels in venous blood or intracoronary samples obtained prior to angioplasty. Also, there was no translesional (proximal and distal to the lesion) gradient in any of the hemostatic markers before or after angioplasty in samples obtained between 18 and 21 min from the onset of the first balloon inflation. Furthermore, no significant difference was noted between angioplasty and postangioplasty intracoronary concentrations. We conclude that intracoronary hemostatic activation does not occur in the majority of patients during and immediately following coronary angioplasty when high doses of heparin and aspirin are administered.

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Effect of Concentration of Trisodium Citrate Anticoagulant on Calculation of the International Normalised Ratio and the International Sensitivity Index of Thromboplastin

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648816 ◽

1994 ◽

Vol 72 (01) ◽

pp. 084-088 ◽

Cited By ~ 29

Author(s):

E M Duncan ◽

C R Casey ◽

B M Duncan ◽

J V Lloyd

Keyword(s):

Reference Material ◽

Oral Anticoagulants ◽

Reference Method ◽

Trisodium Citrate ◽

Sensitivity Index ◽

Blood Samples ◽

Orthogonal Regression ◽

Significant Difference ◽

International Normalised Ratio ◽

International Sensitivity Index

SummaryThe aim of this study was to determine whether the concentration of trisodium citrate used to anticoagulate blood has an effect on the INR of the sample and the ISI of the thromboplastin. Five thromboplastins including and Australian reference material were used to measure the prothrombin time of normal and patient samples collected into two concentrations of trisodium citrate - 109 mM and 129 mM. There was no effect of citrate concentration on the INRs determined with the reference material. However for the other four thromboplastins there was a significant difference between INRs for the two citrate groups. The prothrombin times of the samples collected into 129 mM were longer than those collected into 109 mM. This difference was only slight in normal plasma but more marked in patients receiving oral anticoagulants, causing the INRs for patient plasmas collected into 129 mM citrate to be higher then the corresponding samples collected into 109 mM citrate.From orthogonal regression of log prothrombin times by the reference method against each thromboplastin, we found that the ISI for each thromboplastin was approximately 10% lower when determined with samples collected into 129 mM citrate than with samples collected into 109 mM. These results suggest that the concentration of trisodium citrate used for collection of blood samples can affect the calculation of the INR and the calibration of the ISI of thromboplastin. This was found both for commercial thromboplastins prepared by tissue extraction and for a recombinant tissue factor.

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The Effect of Venous Occlusion on the Sequestration of Blood Platelets

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649022 ◽

1972 ◽

Vol 28 (03) ◽

pp. 383-392 ◽

Cited By ~ 1

Author(s):

J Hladovec ◽

Z Koleilat ◽

I Přerovský

Keyword(s):

Blood Platelets ◽

Venous Blood ◽

Venous Occlusion ◽

Blood Samples ◽

Pronounced Decrease ◽

Platelet Counts ◽

Human Volunteers ◽

Opposite Change

SummaryThe venous occlusion of all four legs in rats caused a highly significant decrease of platelet counts in venous blood especially after the correction for an opposite change in haematocrit. A very pronounced decrease in platelets was observed in human volunteers after a venostasis in one arm in the blood drawn from the occluded limb just before the release of occlusion. Similar decreases were found after a venostasis of both legs in postocclusion blood samples. The decrease in blood platelets results from temporary sequestration in the occluded limbs. The decreases of platelets after a 10 min occlusion of both legs are more pronounced in patients with post thrombotic states.

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