Antibody immobilization on swollen polystyrene tubes for the radioimmunological determination of total human serum IgE.

A new technique for preparing activated polystyrene tubes was developed involving the controlled swelling of plastic. The quantity of antibodies immobilized on these tubes, and consequently the quantity of bound IgE, was considerably increased. Calibration curves were plotted and the determination of total IgE in 200 serum samples confirmed the expected increase in sensitivity compared to a standard method. The manufacturing procedure was simple and could easily be automated. Thus, swollen polystyrene tubes constitute an advantageous solid stage in the assay of total IgE, which can improve the sensitivity of various radioimmunological determinations.

[Determination of the factor VIII ristocetin cofactor (Willebrand factor) using a semi-quantitative slide test. Preliminary results]. / Dosage du facteur VIII cofacteur de la ristocétine (facteur Willebrand) à l'aide d'un test sur lame semi-quantitatif. Résultats préliminaires.

The assay of factor VIII, co-factor of Ristocetin (VIIIR:Co) is a relatively delicate procedure which is presently reserved to specialized laboratories. It requires the use of an aggregometer and a long and difficult preparation of human platelets. In parallel with this classical method, we have used a new, rapid, semi-quantitative slide test whose advantages are: simple technique and rapid answer (2 minutes), small volume of plasma required for the test (50 microliters) and the possibility of using citrated or heparinized plasma taken form a venous or capillary blood sample. Using this test, we have assayed factor VIII co-factor of ristocetin: in 31 hospitalized adults patients with no previous history of bleeding and no disturbance of haemostasis and in 18 patients with Willebrand's factor deficiency in comparison with the standard technique using aggregometry (Allain's method); - in 28 normal neonates, in comparison with the VIIIR:Ag factor assay (Laurell's technique), only because of the small sample volume available; - in 17 patients with various disease associated with an abnormality of the VIII complex in comparison with the assay of VIIIR:Ag and VIIIC. The results obtained in the normal adults show a satisfactory correlation between the two methods. The mean level of factor VIII:Co is 100 +/- 10 per cent (M +/- SD) with the semi-quantitative slide test and 109 +/- 20 per cent (M +/- SD) with the method taken as the reference. The correlation is also satisfactory for patients with a deficit of Willebrand's factor. The test performed on the neonates gives a mean value of 101 +/- 37 per cent (M +/- SD) with good correlation between the factor VIIIR:Ag and the factor VIIIR:Co.

[Feasibility of patient-injected anticoagulation therapy: the GRANTED experience]. / Faisabilité pratique de l'auto-injection des traitements anticoagulants: l'expérience du réseau GRANTED.

BACKGROUND: Injectable anticoagulation therapy is indicated for several months following diagnosis of venous thromboembolic disease (VTE) in a context of active neoplasia. Certain studies have shown an improvement in patient compliance using self-injections. PURPOSE: Allow patients to safely make their own injections of anticoagulants after checking their aptitude and motivation. METHODS: At the prescribing physician's request, the GRANTED network provided patients and/or the resource person with specific education and training. The educational program was proposed to patients with an indication for a treatment for at least 3 months. After becoming familiar with the injection material and its manipulation, the patient and/or resource person performed sham injections on test materials. Patients were then allowed to decide for themselves whether or not to participate in the self-injection protocol. The prescribing physician received a report from the training team. RESULTS: From November 2010 to July 2012, 39 patients participated in the educational program, generally in a context of vitamin K antagonist prescriptions. Sixteen of these patients had a neoplasia. The educational program corrected erroneous or imprecise points of information, particularly concerning syringe purging. DISCUSSION: The education program proved to be interesting for points other than those initially foreseen and allowed the team to rectify a certain number of erroneous messages unrecognized by the prescribing physicians. This result goes in line with the need for accompanying patients who have a prescription for self-injections and also emphasizes the need for careful follow-up.

[Evaluation of an education program for patients taking oral anticoagulants: Experience of the GRANTED network in Isère]. / Evaluation d'un programme d'éducation thérapeutique pour les traitements anticoagulants oraux : expérience du réseau Ville-Hôpital GRANTED du secteur Sud-Isère.

BACKGROUND: The guidelines for good clinical practices issued by the French Agency for Health and Drug Safety and the Superior Health Authority are designed to improve management of oral anticoagulants which can be an important source of iatrogenic morbidity. These guidelines have focused on the need for special education. The GRANTED network in Isère developed an education program for patients taking oral anticoagulants. OBJECTIVE: The purpose of this study was to evaluate quantitatively the therapeutic education of these patients taking oral anticoagulation, irrespective of their risk factor(s). PATIENTS AND METHODS: This was a retrospective analysis of 100 randomly selected patients taking oral anticoagulants for at least three months who participated in the GRANTED education program in 2007. The evaluation criterion was the number of hemorrhagic and/or thromboembolic events. RESULTS: Among the 97 patients contacted, 3.1% had a serious hemorrhagic event and 1.03% a recurrent thromboembolic event. CONCLUSIONS: The quality of a scientific study depends on the quality of the methodology, leading to a preference for prospective studies. It would nevertheless be pertinent to determine whether or not official management recommendations are applied correctly in real life conditions. We report a first evaluation of a therapeutic education program designed for patients taking oral anticoagulants. The education program within the GRANTED network has enabled a reduction in the iatrogenic morbidity related to oral anticoagulation despite the selection bias of the probably high-risk population enrolled in the GRANTED network.

Role of radiography in the diagnosis of mucoceles.

The role of radiography is of the utmost importance in the diagnosis of mucoceles. The use of plain films and tomograms enabled us to make the exact diagnosis of mucocele 19 out of 26 times. The patients had a mechanical proptosis, one sinus with a subnormal transparency was enlarged, and its walls were either thinned or broken at the place of a structural process of alteration. Orbital venography shows the venous shifting and ascertains the posterior extension and the extra-conal location of the tumour.

Multidirectional reconstruction of angiograms by stereogrammetry and computer. Application to computed tomography.

A technique of reconstruction of angiograms in any projection, by stereogrammetry and computer, is described. Sections of the vessels may be obtained and superimposed on CT sections.

Radioimmunological determination of total thyroxin by antibodies immobilized on polystyrene tubes coated with styrene-maleic anhydride copolymers.

In this new technique for preparing activated polystyrene tubes for assay of human thyroxin (T4) we coated plastic with styrene-maleic anhydride copolymers. The quantity of antibodies immobilized on these tubes was considerably greater than on non-activated polystyrene tubes, and the time required for immobilization was shortened. Calibration curves were plotted, and determination of total T4 in 200 serum samples confirmed the expected increase in sensitivity as compared with a commercial (Gammacoat) method. The manufacturing procedure is simple and could easily be automated. Thus, such copolymer-coated tubes constitute an advantageous and reliable component in the assay of total T4 that can be used to improve the sensitivity of this and various other radioimmunological determinations.

[Prevention of postoperative thrombo-embolic accidents following thoracic surgery by low-dose calcium heparinate: a comparative study (author's transl)]. / Essai de prévention des accidents thromobo-emboliques post-opératoires par les faibles doses d'héparinate de calcium en chirurgie thoracique.

A comparative clinical trial was undertaken in 2420 patients undergoing thoracic surgery during a 4-year period (1973-1977); 40% of the patients had bronchial cancer. Random allocation was not considered as being possible by the surgeons and was replaced by allocation according to the time of operation. There were three protocol groups: Protocol A: First morning operations (1007 patients): subcutaneous calcium heparin, 5000 units (Ul) 2 hours and 30 minutes before surgery then every 12 hours for 15 days. Protocol B: Second morning operations (932 patients): same dose and duration of treatment; the first injection took place 24 to 72 hours after the surgical procedure. The doses were increased from the fourth day after surgery in order to obtain a moderately prolonged partial thromboplastin time (difference patient-control: 7 to 14 seconds). Protocol 0: 481 patients received no anticoagulant treatment because of a contraindication or minor surgical procedure. Preliminary results showed and increase of per-operative bleeding (p less than 0.01) in treated patients; this was very well accepted by the surgeons. Among the heparin-treated patients, 11 pulmonary emboli out of 13 were observed in patients with bronchial cancer. Of these 13, 10 were fatal with 9 being verified at autopsy. The pulmonary emboli episodes occurred significantly earlier in protocol B than in protocol A. Fatal pulmonary embolism in patients with bronchial cancer was significantly more frequent in protocol B (7 cases) than in protocol A (1 case); P less than 0.01. These results have shown a low frequency of fatal pulmonary emboli in patients without bronchial cancer receiving twice-daily subcutaneous injections of heparin (2 of 1102 operated subjects). The rate was higher in patients with bronchial cancer and this results supports a recommended thrice-daily dose in such patients. In addition, the pre-operative administration of heparin is useful in preventing early post-operative pulmonary embolism.