Combating abuse, Part II. Protecting the child.
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Biomedical subjects
Publications and source records attributed to A Fagin.
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The LDH isoenzyme composition of 12 platelet preparations was determined by electrophoresis. The mean (+/- SD) percentages of LDH-1, LDH-2, LDH-3, LDH-4, and LDH-5 were 16.6 +/- 1.7, 30.1 +/- 1.0, 34.2 +/- 1.3, 18.2 +/- 1.3, and 0.9 +/- 1.1, respectively. In comparison with previous data, these data show identical ranking of the prevalence of each isoenzyme but significantly different percentages, particularly of LDH-1 and LDH-4. The release of platelet LDH by freezing and thawing differed little from that by homogenization.
The activated partial thromboplastin time after heparin removal (aPTT/HR) is an anionexchange procedure that permits the unobstructed monitoring of the progress of coumarin anticoagulation by removing interfering heparin. An all-intrinsic-pathway anticoagulant surveillance scheme based upon the aPTT/HR has been proposed and provisionally tested. The adoption of the new scheme will depend upon the identification of partial thromboplastins that are as predictable and reliable as the tissue thromboplastins in modern one-stage prothrombin times. In this study, the commercial APTT Reagent and Simplastin performed with equal sensitivity and specificity when evaluated by means of prothrombin group factor assays on coumarintreated subject plasmas. It is concluded that this commercial partial thromboplastin (1) is capable of being used for the purpose of following heparin, heparin plus coumarin, and coumarin anticoagulation; (2) is potentially able to identify more of the inherited and acquired derangements that can lead to anticoagulation-associated hemorrhage; and (3) is a universally available alternative to the traditional anticoagulant monitoring approach.
Activated partial thromboplastin time after heparin removal (aPTT/HR), a test employing anion exchange chromatography, was devised as an alternative to the prothrombin time after heparin removal (PT/HR) to monitor simultaneous anticoagulation with heparin and coumarins. The potential utility of the aPTT/HR was assessed by performing parallel PTs and aPTTs on 62 consecutive plasmas from coumarin-treated outpatients. All samples had 0.2 units/ml of heparin added and then removed to see if the maneuver influenced therapeutic group assignment. In no instance did reassignment occur. A conditional Irwin-Fisher test (P = 0.000604) and a special multinomial trial analysis (P = 0.002) indicated that the aPTT would be at least comparable to the PT for following coumarin antithrombotic prophylaxis. Since the heparin removal procedure had no influence on therapeutic categorization, the same statistical proof could be applied to the relationship between aPTT/HR and PT/HR. This study indicates that the aPTT can be used to monitor all stages of heparin and /or coumarin anticoagulation.
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