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.

[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.

[Linezolid, the first oxazolidinone antibiotic]. / Le linézolide, premier antibiotique de la famille des oxazolidinones.

The spread of multiresistant Staphylococcus and Enterococcus strains required the development of new drugs. Linezolid is the first molecule of a new antibiotic family, oxazolidinones, with an original mechanism of action. In this general review, the authors first present its antibacterial activity, its pharmacokinetic properties, its therapeutic uses in serious Gram-positive infections, pneumonia, skin and soft tissue infections, and also in other indications. They then explain the rules for administration and tolerability.

Stump infections after major lower-limb amputation: a 10-year retrospective study.

BACKGROUND AND PURPOSE: There is little published data on the diagnostic and therapeutic management of lower-limb stump infections (excluding toe and forefoot amputations). PATIENTS AND METHODS: We made a retrospective observational study of 72 patients having undergone a major lower-limb amputation for a vascular or traumatic reason, complicated by post-surgical stump infection, between January 1, 2000 and December 31, 2009. RESULTS: Stump infection was diagnosed more than 6weeks after amputation in half of the patients. Staphylococcus was the most frequently isolated bacterium. Ultrasonography and CT scan combined with fistulography were useful to confirm the diagnosis and to determine the extension of infection. Thirty-two patients (44%) needed surgical revision in addition to antibiotic treatment. Patients diagnosed with bone infection more frequently required complementary surgery than those with soft tissue infection (P<0.001). CONCLUSION: The optimal management of this type of infection requires obtaining reliable bacteriological documentation (abscess aspiration in case of soft tissue infection or bone biopsy in case of osteomyelitis) to adapt to the antibiotic treatment. The management should be multidisciplinary (orthopedic or vascular surgeons, rehabilitation specialists, and infectious diseases physicians). Most patients may use prosthesis once the infection is treated.