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Biomedical subjects

Françoise Boehlen

Publications and source records attributed to Françoise Boehlen.

15 recordsLinked to original sources
PubMed2005

Agreement of a new whole-blood PT/INR test using capillary samples with plasma INR determinations.

PURPOSE: The objective of the study was to compare in anticoagulated patients the international normalized ratio (INR) measured with a new capillary whole-blood device, the i-STAT Portable Clinical Analyser, with conventional plasma INR obtained from the central laboratory. PATIENTS AND METHODS: Between-cartridge variability was first determined with two lyophilized controls with INR levels of 1.60 and 2.75 (n=10). Next, in 35 patients under different intensities of oral anticoagulation, capillary blood INR was measured with two i-STAT devices and was compared to central laboratory plasma INR (Innovin reagent and BCS analyser). RESULTS: Between-cartridge coefficients of variation were 5% (95%, CI 3.4-9.1) and 3% (95%, CI 2.1-5.5) at INR levels of 1.60 and 2.75. Mean INR difference between the two i-STAT devices was 0.1, and the correlation coefficient was 0.98. Between i-STAT and central laboratory INR, the correlation coefficient was 0.95. Bias values were 0.04, 0.2, and -0.04 at INR levels of 2.0, 2.5, and 3.5, respectively. CONCLUSION: The INR measured with the i-STAT Portable Clinical Analyser is precise and compares well with plasma INR performed in a central laboratory.

Anticoagulants↗
PubMed2004

Severe factor XI deficiency in a Lebanese family: identification of a novel missense mutation (Trp501Cys) in the catalytic domain.

In this study, a Lebanese woman with severe factor XI deficiency as well as several unaffected family members were analysed. The F11 gene was screened by polymerase chain reaction amplification of all 15 exons, including intron-exon junctions followed by single-strand conformational analysis. Variant single-strand conformational analysis profiles were obtained for exon 13; sequencing of these products allowed the identification of a novel missense mutation (Trp501Cys) situated in the catalytic domain, in homozygosity in the proband.

Adult↗
PubMed2004

Purpura fulminans in a child as a complication of chickenpox infection.

Purpura fulminans is a thrombotic disease that can occur during infections, disseminated intravascular coagulation or in the context of an acquired or congenital protein C or S deficiency. Here we report the case of a 4-year-old child who developed, 5 days after a chickenpox infection, large painful ecchymotic, necrotizing and retiform plaques on the lower extremities. Laboratory analyses revealed very low protein S levels as well as anticardiolipin antibodies. Aggressive treatment by low-molecular-weight heparin, steroids, intravenous immunoglobulins and fresh frozen plasma was able to prevent the extension of the lesions and to correct the coagulation abnormalities. No lesions required skin grafting. As in our patient, an acquired protein S deficiency is probably responsible for most cases of purpura fulminans occurring after varicella, but the concomitant presence of antiphospholipid antibodies may also play a role.

Antibodies, Anticardiolipin↗
PubMed2003

[Thrombophilias].

Thrombophilia can be defined as congenital and acquired disorders of the blood coagulation system which are associated with thrombosis. Numerous abnormalities linked with venous thromboembolism have been described recently. Among the different possibilities, it is crucial to order tests which can really modify the therapeutic attitude towards the patient and/or his family. The present review tries to provide some answers; however the recommendations should be considered as provisional, because new findings and study results will certainly modify them in the near future.

Humans↗
PubMed2003

HPA-genotyping and antiplatelet antibodies in female blood donors.

Cases of passive alloimmune thrombocytopenia have been reported due to transfusions of blood products with antiplatelet antibodies. The aim of our study was to search for antiplatelet antibodies in HPA-homozygous blood donor women once pregnant and also to perform, in case of positivity, a retrospective analysis of platelet counts of the recipients of their blood products. HPA-1, -2, -3 and -5 genotyping were performed on 500 platelet donors (42% women). Circulating antiplatelet antibodies were screened for by MAIPA assay in 122 women who experienced at least one pregnancy and who were homozygous for either HPA-1a, -1b, -3a, -3b, -5a or -5b. None of the women homozygous for HPA-1 or -3 had circulating antiplatelet antibodies. In contrast, two of the 98 women homozygous for HPA-5a and one of the two women homozygous for HPA-5b had circulating antibodies. A retrospective analysis of the medical charts of the 37 recipients of 55 blood components from these three women showed no case of passive alloimmune thrombocytopenia. Our study indicates the presence of platelet-specific antibodies in 2.5% of HPA-homozygous female platelet donors who were previously pregnant. Although none of the recipients developed passive alloimmune thrombocytopenia, this aspect of blood transfusion safety should be addressed by a large prospective trial.

Antigens, Human Platelet↗
PubMed2003

[Study of primary hemostasis in vitro with the Platelet Function Analyzer (PFA-100)].

The PFA-100 is a device recently introduced to explore primary haemostasis in vitro with citrated whole blood at high shear stress. Main pre-analytical variables are platelet count, haematocrit and citrate concentration. The sensitivity for factor von Willebrand deficiency is excellent, albeit lower for platelet dysfunctions. Its performances for the monitoring of antiplatelet treatments have not been yet established by clinical trials. The PFA-100 is very sensitive to fibrinogen receptors inhibitors; for aspirin the sensitivity depends on inter-individual variations and on the dose administered. We still lack studies to estimate its performances for the prediction of peri- and post-operative bleeding in heavy surgery, the pre-operative values have been proved not discriminant. This device appears an useful complement to aggregometry.

Blood Platelet Disorders↗
PubMed2002

Acquired and transient RBC CD55 deficiency (Inab phenotype) and anti-IFC.

BACKGROUND: Antigens of the Cromer blood group system reside on the glycoprotein CD55 (decay-accelerating factor). The Inab phenotype is the null phenotype of this system. So far, only five propositi have been described who exhibit this phenotype, and single-nucleotide substitutions in the CD55 gene have been found in three of them. This report describes the first example of a patient with an acquired and transient form of the Inab phenotype. CASE REPORT: A 54-year-old black patient was admitted to the hospital because of abdominal pain. Multiple splenic infarctions were visualized in the abdominal computerized tomography scan, and a prophylactic splenectomy was performed. The patient's serum reacted by an IAT with all donor RBCs tested. RESULTS: Serologic analysis showed that the patient had the rare Inab phenotype and that his serum contained anti-IFC. Flow cytometry demonstrated the absence of CD55 on his RBCs, whereas lymphocytes, monocytes, granulocytes, and platelets expressed CD55, albeit at a weaker level than cells of common phenotypes. cDNA revealed no differences from the published sequences. Flow cytometry performed 12 months after splenectomy showed reappearance of the CD55 antigen; serologic tests performed after 17 months revealed that the anti-IFC had almost disappeared and that the RBCs were again agglutinated by various Cromer antibodies. CONCLUSION: A patient with an acquired and transient form of the Inab phenotype is described, in whom the CD55 deficiency is limited to the RBCs and is associated with splenic infarctions.

Abdominal Pain↗
PubMedDate not supplied

Two new antithrombotic agents (fondaparinux and ximelagatran) and their implications in anesthesia.

PURPOSE: To describe two new antithrombotic agents (fondaparinux and ximelagatran), their mechanisms of action, the clinical studies available and some implications (regional anesthesia, monitoring and antidote) in anesthesia. SOURCE: Recently published articles on these two new drugs were reviewed. PRINCIPAL FINDINGS: These two drugs have several interesting properties. Both are of non animal origin, do not induce thrombocytopenia and do not require laboratory controls. In recent studies fondaparinux has shown a better efficacy than low molecular weight heparin in major orthopedic interventions. Ximelagatran, which can be given orally and is in phase III investigation, could replace vitamin K antagonist in the future. CONCLUSION: Anesthesiologists should be aware of these two new agents, one (fondaparinux) being now already registered in some countries.

Anesthesia, Conduction↗