148 research outputs found
Profile of Instrumentation Laboratory's HemosIL® AcuStar HIT-Ab(PF4-H) assay for diagnosis of heparin-induced thrombocytopenia.
No full textINTRODUCTION
Immunoassays play an essential role in the diagnosis of heparin-induced thrombocytopenia (HIT). The objective of this article is to review HemosIL® AcuStar HIT-Ab(PF4-H) (Instrumentation Laboratory, Bedford, MA, USA), a new chemiluminescent immunoassay for HIT. Areas covered: The authors searched the published literature for evaluation studies of HemosIL® AcuStar HIT-Ab(PF4-H) and sought information from the manufacturer. In this paper, the authors discuss the analytical principle and technical aspects of the assay; describe its diagnostic performance in validation studies; report on its reproducibility, cost-effectiveness, and regulatory status; and discuss the implications of the assay on clinical practice and means of integrating it in diagnostic pathways. HemosIL® AcuStar HIT-Ab(PF4-H) is compared with other rapid assays and widely used enzyme-linked immunoassays for the diagnosis of HIT. Expert commentary: HemosIL® AcuStar HIT-Ab(PF4-H) is automatable, can be performed 24 h per day, offers a rapid turnaround time, and appears to have favorable diagnostic accuracy, particularly at thresholds above that listed in the label. These advantages could lead to improved patient outcomes through rapid provision of results at the point of care, enhancing the accuracy of initial diagnosis
MSJ816612_supplementary_info – Supplemental material for Immune thrombocytopenia in alemtuzumab-treated MS patients: Incidence, detection, and management
No full textSupplemental material, MSJ816612_supplementary_info for Immune thrombocytopenia in alemtuzumab-treated MS patients: Incidence, detection, and management by Adam Cuker, Ann D Bass, Congor Nadj, Mark A Agius, Brian Steingo, Krzysztof W Selmaj, Timothy Thoits, Alexandre Guerreiro, Bart Van Wijmeersch, Tjalf Ziemssen, Sven G Meuth, Christopher C LaGanke, Karthinathan Thangavelu, Claudio E Rodriguez, Darren P Baker, David H Margolin and Ann Jannsens in Multiple Sclerosis Journal</p
Comparative effectiveness and safety of anticoagulants for the treatment of heparin‐induced thrombocytopenia
No full textBACKGROUND
The effectiveness and safety of non-heparin anticoagulants for the treatment of heparin-induced thrombocytopenia (HIT) are not fully established, and the optimal treatment strategy is unknown. In a systematic review and meta-analysis, we aimed to determine precise rates of platelet recovery, new or progressive thromboembolism (TE), major bleeding, and death for all non-heparin anticoagulants and to study potential sources of variability.
METHODS
Following a detailed protocol (PROSPERO: CRD42020219027), EMBASE and Medline were searched for all studies reporting clinical outcomes of patients treated with non-heparin anticoagulants (argatroban, danaparoid, fondaparinux, direct oral anticoagulants [DOAC], bivalirudin, and other hirudins) for acute HIT. Proportions of patients with the outcomes of interest were pooled using a random-effects model for each drug. The influence of the patient population, the diagnostic test used, the study design, and the type of article was assessed.
RESULTS
Out of 3194 articles screened, 92 studies with 119 treatment groups describing 4698 patients were included. The pooled rates of platelet recovery ranged from 74% (bivalirudin) to 99% (fondaparinux), TE from 1% (fondaparinux) to 7% (danaparoid), major bleeding from 1% (DOAC) to 14% (bivalirudin), and death from 7% (fondaparinux) to 19% (bivalirudin). Confidence intervals were mostly overlapping, and results were not influenced by patient population, diagnostic test used, study design, or type of article.
DISCUSSION
Effectiveness and safety outcomes were similar among various anticoagulants, and significant factors affecting these outcomes were not identified. These findings support fondaparinux and DOACs as viable alternatives to conventional anticoagulants for treatment of acute HIT in clinical practice
Transitioning patients with immune thrombocytopenia to second‐line therapy: Challenges and best practices
No full text
Social reflexivity and education: the case of marking
No full textThe Bachelor's thesis, Social Reflexivity and Education: the case of marking, is a quantitative research study that examines social reflexivity in first stage primary school teachers, specifically focusing on assessment. The main goal of the thesis is to map teachers' decision- making processes regarding changes in their practice and the extent to which they use marking, or verbal assessment, using social reflexivity theory. First, the author focuses on the changes that teachers make in their general practice. In what ways they make changes and how they think about them. Next, he reflects on the incentives that make teachers' changes happen. The author also focuses on several dimensions that enter the decision-making process of deciding the extent to which the aforementioned types of evaluation are used. The first is the progressiveness of teachers, their relationship to tradition and continuity in education. Next, their relationship to marking and verbal assessment and their perception of their individual characteristics. The author also discusses the structures that teachers perceive as limiting in reducing the use of grades in teaching. Finally, the author reflects on distance learning during the covid-19 pandemic and its impact on the use of verbal assessment and on structure
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