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  ABSTRACT BACKGROUND: Despite recent improvements in the treatment of cancer, little is known about the long-term survival in patients with cancer and venous thromboembolism. We aimed to examine the five-year mortality of venous thromboembolism in cancer patients in a large population-based cohort study. METHODS: Using Danish healthcare registries from 1995 to 2020, we obtained data on cancer patients with venous thromboembolism and comparison cohorts of cancer patients without venous thromboembolism, matched in terms of cancer type, age, sex, and year of cancer diagnosis, and adjusted for level of comorbidity and frailty using the Charlson Comorbidity Index Score and Hospital Frailty Risk Score, marital status, use of selected medications, and recent surgery (<90 FINDINGS: During the study period, 886,536 patients were diagnosed with cancer. Of 1882 cancer patients diagnosed at the time of their venous thromboembolism, 44.4% (835/1882) had distant metastases. In this cohort, the o

  ABSTRACT BACKGROUND: Incidence of and risk factors for bleeding in cancer patients with venous thromboembolism (VTE) treated with apixaban are poorly described. METHODS: We analyzed data from the prospective CAP study where 298 cancer patients with any type of VTE received 5 mg apixaban twice daily for 6 months, and then 2.5 mg apixaban twice daily for 30 months. For most analyses major bleedings and clinically relevant non-major bleedings were merged to "clinically relevant bleedings". Risk factors were estimated by odds ratios (OR) and 95% confidence intervals (CI). RESULTS: The incidence of clinically relevant bleedings was 38% per person year during the first 6 months of treatment, 21% per person year from 7 to 12 months, and between 4% and 8% per person year from 13 to 36 months. Clinically relevant bleedings were associated with age above 74 years (OR 2.0, 95% CI 1.0-4.1), BMI below 21.7 (OR 2.3, 95% CI 1.1-4.8), and hemoglobin at baseline below 10.5 for females (OR 2

  and the severity of the bleeding is proportional to the degree of deficiency. In order to treat the hemorrhagic condition, it is important to identify and quantify the deficient factor. Fibroscreen reagent is one such test reagent, which can identify the deficiency of factor I (fibrinogen). The reagent is used as a source of thrombin to determine the qualitative reactivity of fibrinogen. Reagent Fibroscreen reagent is a lyophilized preparation of bovine thrombin of 50 NIH/mL. Reconstitute with 1 mL of distilled water; wait for 5 minutes, do not shake and mix gently by swirling till the solution attains homogeneity. Further keep aside for 10 minutes to attain equilibrium. Gently swirl the vial while drawing the reagent for use. Once reconstituted it is ready to use reagent for the thrombin time test. Storage and Stability 1. Store the unopened reagent vials at 2–8°C. Do not freeze. 2. The shelf-life of the reagent is as per the expiry date mentioned on the reagent vial label and carto

1. In vitro diagnostic reagent for laboratory and professional use only. Not for medicinal use. 2. The source material used for preparation of the reagent is screened by third generation assays for HBsAg, HCV and HIV antibodies and are found to be non-reactive. However, handle the material as if it is infectious, as no known test method can assure that infectious agents are absent. Preparation of the Reagent 1. Reconstitute the control plasma with exactly 1 mL of bi-distilled water. Avoid using water-containing preservatives. 2. Re-stopper the vial and allow to stand until, the hydration is complete (usually 5–7 minutes). 3. Mix by gently swirling and inversion, avoiding froth formation. Do not shake. 4. Allow to stand and equilibrate for a further 15 minutes before use. 5. Use the reconstituted plasma within 3 hours of reconstitution. Test Procedure 1. Use the reconstituted Plasmatrol controls in the same manner as freshly prepared titrated platelet poor plasma from a patient. 2. Use

  Calibration Curve Method Heparin concentration in the test sample can be directly obtained from the Liquicelin-E calibration curve by interpolating the test plasma clotting time against the heparin concentration in U/mL. Expected Values Normal values using Liquicelin-E reagent are between 21 and 29 seconds at 3 minutes activation time. Between manual and turbodensitometric instrument results a variation of 1-2 seconds may be expected. For photo-optical instruments, it is recommended that each laboratory must establish their own normal range. Remarks 1. Due to inter and intralaboratory variations users must establish their own normal population range as well as normal and abnormal range. 2. It is recommended that controls with known factor activity should be run simultaneously with each test series routinely. 3. Incorrect mixture of blood and trisodium citrate, insufficient prewarming of plasma and reagent, contaminated reagents, glassware, etc. are potential source of errors. 4. In

  Reagent Liquicelin-E is a liquid ready to use activated cephaloplastin reagent for the determination of activated partial thromboplastin time. It is a phospholipid preparation derived from rabbit brain with ellagic acid as an activator. Each batch of reagent undergoes rigorous quality control at various stages of manufacture for its sensitivity and performance. 294 Concise Book of Medical Laboratory Technology: Methods and Interpretations Reagent Storage and Stability a. Store the reagent at 2-8°C. Do not freeze. b. The shelf-life of the reagent is as per the expiry date mentioned on the reagent vial label. The reagent is stable for: 1 year at 2–8°C, 1 week at 18–25°C, 2 days at 37°C. Principle Cephaloplastin activates the coagulation factors of the intrinsic pathway of the coagulation mechanism in the presence of calcium ions. APTT is prolonged by a deficiency of one or more of these clotting factors of the intrinsic pathway and in the presence of coagulation; inhibitors like hepar

  ¾ The correct use of the formula to compute the INR. ¾ Uniform understanding of the INR system by clinicians as well as laboratorians. Patient Variables in PT/INR Testing There are many factors that can influence the results of the PT/INR tests so that they do not reflect the patient’s usual coagulation state. Coagulation tests are susceptible to errors introduced by suboptimal specimen quality because of a number of factors such as blood collection technique, labile state of several coagulation proteins, and laboratory transportation factors. In order to get acceptable accuracy it is important to understand and control these factors as much as possible. Factors that Influence Coagulation Test Results Age and Gender Age specific reference ranges are critical for correct interpretation of coagulation data. Bleeding time declines with age and many coagulation factors increase with age as do markers of coagulation activation. Age and gender can also influence platelet function. Females

  A PT ratio is obtained by dividing the patient PT in seconds by the “mean of the normal range” (MNPT). This ratio is then “normalized” by raising the results to the power of the ISI of the PT reagent used. Lower the ISI of the reagent used, closer will be the INR to the observed PT ratio. Ideally, when the ISI of the reagent is 1.0 then the INR is a simple PT ratio since (R)1.0 = R. Currently many coagulation instruments are available that can perform this exponential calculation by entering the ISI of the reagent in use. Alternatively a table is provided by reagent manufacturers for reading off “INR” directly for the given patient PT ratio, corresponding to the ISI value of the reagent used. Recommended Therapeutic Ranges for Oral Anticoagulant Therapy Indications INR Intensity • Prophylaxis of venous thrombosis (high risk surgery) • Treatment of venous thrombosis • Treatment of pulmonary embolism • Prevention of systemic embolism – Tissue heart values 2.0–3.0 – Acute my