Assessment of light transmission aggregometry on the routine coagulation analyzer Sysmex CS-2500 using CE-marked agonists from Hyphen Biomed.

Light transmission aggregometry (LTA) is still considered as the "gold standard" for platelet function assessment but, as acompletely manual technology, it is labour intensive. This challenge can be overcome by performing platelet aggregometry in anautomated method on a routine coagulation analyzer. We aimed to compare and correlate results obtained from a traditional manual LTA solution realized in our Reference Center with an optimized automated system using CE-marked agonist reagents. Platelet rich plasma from patients with suspected platelet disorders, von Willebrand disease or antiplatelet therapy have been assessed using a wide range of agonist concentrations. Results were expressed as Maximal Platelet Aggregation and correlation was analyzed using the Passing and Bablok regression test. Platelet aggregometry studies were performed in 49 samples. Maximal aggregation response with ADP (0.5-10 µM), collagen (2 mg/µL), ristocetin (1.2 mg/mL) and arachidonic acid (1 mM) agonists showed significant correlation between the two aggregometers (p< .001). We observed a more variable response using lowconcentrations of ADP (≤5 µM). Moreover, we also noted discrepancies with the low dose of ristocetin, showing excessive paradoxical agglutination with the CS-2500, suggesting that a lower ristocetin dose should be used with this system. These data show that CS-2500 has the advantages of a walk-away technology and the use of CE-marked reagents also permit the possibility of an easier certification.

[Transfusion and its specific problems in pediatrics and neonatology]. / La transfusion et ses problématiques particulières en pédiatrie et néonatologie.

Principles of transfusion strategy have been used for neonates and children similar to adults. However, due to substantial discrepancies between physiology/pathology in children and in their adult counterparts, decisions, indications, and doses are different from those of adults, especially in neonates. Specific data and practice guidelines for blood product transfusion are reported owing to the experience of pediatrics and neonatology units and partners of the French Blood product bank.

[Intracranial hemorrhage in three haemophilic adults: A severe complication of hemophilia]. / Hémorragie intracérébrale chez trois adultes hémophiles : une complication sévère de l'hémophilie.

BACKGROUND: Intracranial hemorrhage (ICH) complications are uncommon at hemophilic patients. OBSERVATIONS: We report three cases of ICH occurring in hemophilic patients. Contributing factors were identified in two patients: hemophilia severity, presence of inhibitor, hepatitis C virus infection, and high blood pressure. No contributing factor was identified in the last patient. CONCLUSION: Rapid diagnosis of ICH is crucial in hemophilic patients. A search for contributing factors, both those specific to hemophilia, and those favoring ICH in the general population, is essential to optimize therapeutic care. Specific substitutive treatment for the deficient factor is a difficult management challenge.

[Regional surveillance of the evolution of methicillin resistant Staphylococcus aureus (MRSA): what results for what teaching?]. / Surveillance régionale de l'évolution de Staphylococcus aureus résistant à la méticilline (SARM): quels résultats pour quels enseignements?

OBJECTIVE: The aim of this study was to describe the evolution of MRSA within hospitals located in Franche-Comté from 1999 to 2003 and to establish the MRSA risk according to the type of hospitalization. METHODS: Surveillance of multidrug resistant bacteria was carried out according to the French national guidelines for the prevention of nosocomial infections. RESULTS: The global incidence of MRSA colonized/infected patients (screened by clinical samples) per 1000 patient-days had decreased from 0.73 in 1999 to 0.58 in 2003 (P < 0.004). However, analyzing the results according to each type of hospitalization revealed great heterogeneity. In 2003, the increase of MRSA incidence in short-term public hospitalization was indeed alarming whereas MRSA risk had regularly decreased in the other hospitalization types (rehabilitation and long-term care-facilities) since 1999. The number of potentially serious colonizations/infections caused by MRSA (bacteremia, deep infections, and pulmonary infections) accounted for 12.8% of all colonizations/infections. CONCLUSION: MRSA, in spite of improved prevention in our region, remains responsible for numerous infections.