The missing slope: paradoxical shortening of activated partial thromboplastin time in a patient on unfractionated heparin therapy     

Ivana Lapi&#x;  Ana Lon ar Vran i&#x;  Dsire Coen Herak  Dunja Rogi&#x; 《Biochemia medica : ?asopis Hrvatskoga dru?tva medicinskih biokemi?ara / HDMB》2021,31(2)

This case report describes false shortening of activated partial thromboplastin time (aPTT) due to erroneous optical reading of the clotting point in the presence of unfractionated heparin (UFH), and a biphasic waveform. Activated partial thromboplastin time performed on a coagulometer with photo-optical detection yielded an ambiguous clotting curve characterized by an early and steady decrease in light transmittance throughout the whole measuring range, with the clotting point read at 65 seconds. Further investigations included measurement of aPTT by means of a mechanical clot detection method as well as determination of another heparin-sensitive coagulation assay, that is thrombin time (TT), both being unmeasurably prolonged (> 150 seconds). Communication with clinicians revealed that the patient was on continuous UFH therapy and had an underlying sepsis, with highly elevated C-reactive protein (289 mg/L). The aPTT measurements requested at three timepoints later during the same day revealed gradual aPTT shortening and unveiled a peculiar biphasic waveform pattern. In this case, unmeasurably prolonged aPTT due to UFH therapy was masked by a biphasic aPTT curve pattern making only the first slope of the biphasic waveform visible within the measuring range. The early decrease in plasma light transmittance mimicked optical changes related to clot formation, thus causing erroneous optical reading and yielding a falsely shortened aPTT. This case emphasizes that such a pattern should be carefully inspected, especially when a combination of a critically ill condition and UFH therapy is present, in order to prevent erroneous reporting of aPTT and potential adverse effects on patient care.  相似文献   

Laboratory professionals’ attitudes towards ISO 15189:2012 accreditation: an anonymous survey of three Croatian accredited medical laboratories     

Ivana Lapi&#x;  Dunja Rogi&#x;  Matea Ivi&#x;  Marina Tomi evi&#x;  Mirjana Mariana Kardum Paro  Lovorka &#x;erek  Ines Alpeza Viman 《Biochemia medica : ?asopis Hrvatskoga dru?tva medicinskih biokemi?ara / HDMB》2021,31(2)

IntroductionEffective implementation and continual compliance with ISO 15189:2012 require ongoing commitment and active involvement of laboratory staff. Our aim was to assess attitudes regarding accreditation implementation by conducting a survey in three Croatian accredited medical laboratories.Materials and methodsAn anonymous survey consisting of 34 questions was distributed either electronically or in a paper form a week prior to scheduled annual audits. Distributions of answers regarding age, work experience, laboratory workplace, and education level and according to the respective laboratory were compared.ResultsThe overall response rate was 76% (225/297). Preference towards working in an accredited laboratory and a positive attitude were revealed by 70% and 56% participants, respectively, with better process documentation as the main advantage. Only 14% of responders considered themselves completely familiar with ISO 15189:2012. Total of 68% of responders felt that accreditation increases the usual workload, with excessive paperwork as the main contributor. Half of the responders declared partial agreement that accreditation requirements and expectations were clearly explained and claimed that their suggestions were taken into account only occasionally, which was especially emphasized by technical staff. The vast majority (89%) completely follow the prescribed protocols. Only 27% consider turnaround time monitoring useful. Competence assessment is considered efficient by 41% of responders. The majority (73%) prefer an online audit in times of COVID-19.ConclusionsDespite an overall positive attitude towards accreditation, further efforts are needed in providing better education about ISO 15189:2012 for technical staff and modifying formats of competence assessment, in order to achieve better adherence to ISO 15189:2012 requirements.  相似文献   

‘You Had to Cover Nadia Comaneci’: ‘Points of Change’ in Coverage of Women’s Sport     

Dunja Antunovic 《国际体育史杂志》2016,33(13):1551-1573

Abstract

In the 1970s, women’s sport underwent significant change in the United States resulting in an increase of participation opportunities and funding at the interscholastic, intercollegiate, professional and international levels. Yet, media outlets continued to ignore women and, at best, portray them in gender stereotypical ways. Considering the lack of progress for women in sports media coverage, this study employs sport historian Jaime Schultz’s ‘points of change’ framework in order to identify those moments that constituted an ideological shift in the process of covering women’s sport. Drawing upon oral history interviews with journalists who wrote about women’s sport in the 1970s and 1980s, this research provides a deeper look into how journalists experienced and addressed the shifting gender ideologies of the time period. Journalists’ memories, accompanied by their articles, reveal how media practitioners negotiated meanings about femininity and athleticism in response to events that challenged deeply embedded assumptions about gender and its intersections with ethnicity, race and sexuality. This exploratory research, thus, identifies several ‘points of change’ – or points of struggle, conflict and resistance – and calls for a re-periodization of the history of women’s sports coverage.  相似文献   

“Ice Cream is Worse,and Joblessness is Not an Option”     

Dunja Antunovic  Jenna Grzeslo 《Journalism Practice》2019,13(1):52-67

A rise in informal labor, characterized by contracted and non-salaried positions, has been observed in many industry sectors including journalism. While opportunities for freelance journalists have increased, the journalism industry has simultaneously experienced mass layoffs. Using a survey (N?=?411), with quantitative and qualitative measures, this study assesses freelancers’ experiences in the US context with a particular attention to gender. The study finds that women perceive freelancing, but not full-time journalism, as compatible with raising children. Although there were no differences in perceptions about layoffs and job stability, the women in the sample were more likely to rely on freelancing as the only job and subsequently express concerns over pay. Open-ended responses provide further insight into the state of the journalism industry, full-time employment, and gender dynamics.  相似文献   

Haemoglobin A1c-based screening for prediabetes and diabetes mellitus: a multi-center study in Croatian adult population     

Ivana Lapi&#x;  Dunja Rogi&#x;  Nora Nikolac Gabaj  Katarina Kaji&#x;  Nena Peran  Lada Surjan  Anamarija &#x;uras  Valentina Cesar Kocijan  Nada Bilopavlovi&#x;  Fran Smai&#x;  Mario &#x;tefanovi&#x;  Ivanka Ostro&#x;ki  Leida Tandara  Milena Krnjai&#x;-Tadijanovi&#x;  Ivan Gornik  Hrvoje Pintari&#x;  Daniela Marasovi&#x; Krstulovi&#x;  Blaenka Mi&#x;ki&#x;  Dario Raheli&#x; 《Biochemia medica : ?asopis Hrvatskoga dru?tva medicinskih biokemi?ara / HDMB》2022,32(1)

IntroductionBased on the hypothesis that there is a substantial rate of adults with prediabetes and undiagnosed diabetes mellitus (DM), our aim was to perform haemoglobin A1c (HbA_1c)-based screening in a cohort of Croatian adults and estimate the prevalence of prediabetes and undiagnosed DM according to American Diabetes Association criteria.Materials and methodsThis multi-center, cross-sectional study performed in six Croatian hospitals included 5527 patients aged 40 to 70 years admitted to the Emergency Department or undergoing a primary care check-up. Haemoglobin A1c was measured from leftover whole blood samples using the enzymatic method on either Alinity c or Architect c-series analyser (Abbott Laboratories, Chicago, USA). Haemoglobin A1c between 39-47 mmol/mol was classified as prediabetes, while ≥ 48 mmol/mol as undiagnosed DM.ResultsAfter exclusion of 435 patients with known DM, the final cohort included 5092 patients (median age 57; 56% males). A total of 882 (17.3%) patients had HbA_1c values between 39 and 47 mmol/mol. There were 214 (4.2%) patients with HbA_1c ≥ 48 mmol/mol. Prediabetes prevalence ranged from 14.2% to 20.5%, while undiagnosed DM from 3.3% to 7.3%, with statistically significant differences among settings (P < 0.001). Age-stratified analysis showed that prediabetes and undiagnosed DM prevalence increase with age (P < 0.001), being 25.4% and 5.8%, respectively, in patients aged 60 to 70 years.ConclusionUnderlying impairment of glucose metabolism was identified in about one in five adults, with significant number of patients with already overt DM. These results should serve as a starting point for further steps directed towards promotion of preventive measures for DM in Croatia.  相似文献   

Visual and auditory priming influences the production of low-frequency spellings     

Lise Abrams  Dunja L. Trunk  Katherine K. White 《Reading and writing》2008,21(7):745-762

Three experiments investigated whether production of low-frequency spellings could be influenced by other words containing those spellings. Participants saw visually-presented primes (Experiment 1) or heard primes presented auditorily and produced their spelling (Experiments 2 and 3). Primes either shared both orthography and phonology (e.g., chapl ai n) or only orthography (e.g., ord ai n) with the target word (e.g., porcel ai n). Following the primes, participants attempted to produce the correct spellings of auditorily-presented target words containing low-frequency spellings, such as the ai in porcelain. Participants correctly spelled the targets’ low-frequency spelling more often when preceded by either type of prime, relative to unprimed targets. Furthermore, priming only occurred when the prime’s spelling was produced correctly; primes spelled incorrectly reduced the correct production of target spellings. These results suggest that unlike the priming of nonwords, the basis of lexical priming of real words is orthographic, resulting from the priming of specific graphemes that increases the probability of reactivating the same spelling pattern in the target.

Lise AbramsEmail:

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