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Stago Newsletter

Volume 2, Issue 2 August 2011

2 ISTH Internaonal Society on ISTH Thrombosis and Haemostasis

INSIDE THIS ISSUE: The 23rd International Society on Thrombosis and Haemostasis met at Kyoto, Japan from July 23 -28, 2011. ISTH XXIII Kyoto 2 Kyoto ( 京都, Ky ōto, "Capital city") is a city in the central part of the is- Data backup options 3 land of Honsh ū, Japan. It has a population close to

1.5 million. Formerly the Training Needs? 3 imperial capital of Japan, it is now the capital of Kyoto Prefecture, as well as a major part of the architecture intact, it is one those bringing such items The CAT 4 Osaka-Kobe-Kyoto of the best preserved cities would be inclined to metropolitan area. in Japan. answer this truthfully? Luckily I had left my cobra Kyoto is renowned for its Kyoto has a humid sub- at home! Dabigatran 5 tropical climate. The abundance of delicious temperature was 32° Japanese foods and The ISTH meeting was “full

Celsius (overnight 24°C) cuisine. The special on” with 8am starts for the Technical Information 6 and very humid. circumstances of Kyoto as sub committee meetings on a city away from the sea Saturday and Sunday Although ravaged by and home to many followed by the congress wars, fires, and Buddhist temples resulted program running Monday- Dates to Remember 7 earthquakes during its in the development of a Thursday. There were eleven centuries as the variety of vegetables approximately 500 posters

imperial capital, Kyoto peculiar to the Kyoto area . on display each day was spared from much of together with a trade Educational Website 7 The key industry of Kyoto the destruction of World display comprising 49 is information technology War II. It was removed exhibitors. There were over and electronics: the city is from the atomic bomb 4500 delegates in total home to the headquarters target list (which it had attending the sub- of , Intelligent headed) by the personal committees and general Systems, TOSE, , intervention of US congress. Secretary of War Henry L. , Corp., Stimson, as Stimson , Horiba, Diagnostica Stago wanted to save this Corporation, , GS conducted a number of cultural centre which he Yuasa and Murata lunch-time “Meet Our knew from his honeymoon Machinery and the Experts” sessions and a and later diplomatic visits. headquarters of Murata Satellite Symposium titled Manufacturing are located “Can we predict As a result, Kyoto is one in the suburbs of Kyoto in interventions in of the few Japanese cities the city of Nagaokaky ō. Haemostasis and that still has an abun- Sake brewing is Kyoto's Thrombosis.” A CD of dance of prewar buildings, traditional industry. these sessions will be such as the traditional available soon. townhouses known as The first interesting machiya. However, experience was the Diagnostica Stago was a modernization is customs declaration for Silver Sponsor for the ISTH continually breaking down passengers disembarking congress and generously the traditional Kyoto in in Japan. donated furniture and useful items from the favour of newer Am I bringing into the display stand to the architecture, such as the country Narcotic drugs, earthquake/tsunami Kyoto Station complex. Stimulants, Firearms such survivors of Japan. With its 2000 religious as pistols, machineguns, places- 1600 Buddhist bullets, dynamite, swords, Mark your calendars - the temples and 400 Shinto protected animals such as next ISTH is in shrines, as well as crocodiles, cobras, forged Amsterdam 2013. palaces, gardens and credit cards? Quite a (www.isth2013.org) collection and I wonder if

3 A new option for data backup

• The use of external parallel or USB The STA Satellite is ready to add this port printers IMP box funconality with soware version 422.05 (available September This means that you can back up your 2011). sengs, calibraons, and quality Floppy disks and parallel port printers are control for restoring onto the STA The price of the IMP box is only becoming more and more difficult to Compact and STA Satellite at a later $900AUD (+GST) with free installaon. purchase and will one day become me, together with exporng your obsolete. Please contact us to arrange for a free paent files for use on a PC with instrument assessment. Currently the STA Compact and STA Microso Excel. Satellite analysers are not equipped with Email [email protected] If your STA Compact or STA Compact USB ports making it imposible for users to fax +61 3 9855 8999 or CT meets the minimum requirements connect USB keys or USB printers. phone 1800 4 78246 Australia the IMP box can be easily installed by Diagnosca Stago is pleased to announce your Stago representave. 0508 4 78246 New Zealand the availability of the IMP box for: Some older STA Compacts may need • an updated motherboard to allow this Bidireconal data transfer with a USB key funconality which would incur an addional cost. Do you have a need for training?

Training is an integral key to the the training is as follows: easily deal with the more common smooth operation of any lab. Having errors and issues on the analyser. staff who are confident about using their equipment and analysers will help Bench-level training is suitable for make for a happy workplace. scientists / technicians / lab assistants who are performing However, many labs have regular staff routine tasks on the analysers, such turnover and it’s hard to make sure as running samples, loading that everyone is feeling adequately reagents, running QC’s, daily and trained with so many analysers in the weekly maintenance. laboratory. Often, even staff who have been in the lab for a long time feel that they would benefit from ‘refresher’ training. Training can be organized to be done by your local Applications Specialist at a time that suits you

and your laboratory.

To register your interest, please send us an email at [email protected] , or speak to

your local Applications Specialist.

More information is available at Key-operator training is a bit more in-depth, and is aimed at those our website: www.stago.com.au/en/ scientists / technicians who are products-services/stago-customer- looking after test setups, reagent lot services/ongoing-education/

number changes, calibrations, reactive maintenance and troubleshooting.

The reactive maintenance and Stago would like to help you with this troubleshooting aspect can also be by offering both bench-level and very useful for scientists who are on key-operator training for your Stago shifts at times when there is no analysers. All training would be backup as it will give them the tailored to the laboratory and the confidence to be able to quickly and individual participants, but generally

4 Calibrated Automated Thrombogram (CAT) (reprinted due to popular demand)

Diagnostica Stago has recently purchased Why measure thrombin? the Thrombinoscope™ company Thrombin is often seen as the end-product (Netherlands) and can now offer thrombin of the coagulation cascade and as such generation to our ANZ customers. responsible for the final step, the conversion of the soluble protein The Thrombogram describes the fibrinogen into the insoluble fibrin clot. concentration of thrombin in clotting plasma However, the coagulation cascade has so and is therefore a general physiologic many (nested) feedback loops and function test of the thrombotic haemostatic inhibitory pathways that are all directly or system. The CAT measures thrombotic as indirectly influenced by the developing well as bleeding tendency and can be used thrombin concentration that thrombin plays a central and pivotal role throughout the • to measure any genetic or acquired whole process. This makes the description thrombotic disorder such as AT deficiency of the concentration of thrombin in time an or use of oral contraceptives excellent tool to obtain a full picture of • to support the development of coagulability. The method uses the Thrombinoscope™ antithrombotic drugs such as antiplatelet software available from Diagnostica Stago * For Research Use Only. Not for use in drugs and direct inhibitors of thrombin. and is intended for research purposes only. diagnostic procedures. • to monitor the treatment of haemophilic disorders such as treatment More information can be found at with factor VIII, factor VIIa. Our patented technique is measured on a Thrombinograph™, a 96-well plate http://www.thrombinoscope.com/ • to monitor the treatment of thrombotic fluorimeter available from Diagnostica Stago Reagents and consumables are now ANZ (Thermo Scientific Fluoroskan), and disorders such as treatment with oral available from Diagnostica Stago ANZ. anticoagulant drugs (coumarin), any uses a thrombin calibrator that is needed to heparin (UFH, Fraxiparin), antiplatelet correct for inner filter effect, donor-to-donor drugs (Reopro, Clopidogrel) or any variability in colour of plasma, substrate Email [email protected] combination of drugs, to obtain a full picture depletion and instrumental differences. fax +61 3 9855 8999 or phone 1800 4 78246 Australia of the thrombotic tendency of patients at high risk for thrombosis or bleeding. 0508 4 78246 New Zealand Add your reagents to the 9696----wellwell plate… ...and watch the Thrombin generation on your screen

5 A New Oral Anticoagulant— Pradaxa® (dabigatran etexilate)

Atrial Fibrillation (AF) is the most AF at the end of October, 2010. Kind thanks to our Diagnostica common type of cardiac arrhythmia Stago colleagues in the United Dabigatran (Pradaxa ®) is a member or abnormal heart rhythm involving States for this article. of a new class of drugs called Direct the upper two heart chambers. It is Thrombin Inhibitors (DTIs). DTIs are a named for the fibrillations or new class of anticoagulants that bind References: quivering of the heart muscles in the directly to thrombin and block its atria, instead of well controlled and 1. Direct Thrombin Inhibitors, The New interaction with its substrates. coordinated muscle contractions that England Journal of Medicine 2005, 353: Dabigatran inhibits free thrombin, 1028-1040 are normally observed. It is fibrin-bound thrombin, and fibrin- diagnosed by observation of an 2. Journal of Thrombosis and induced platelet aggregation. Other Haemostasis, Volume 7 Supplement 2, abnormal pulse or better yet by the DTIs include argatroban, hirudin, and July 2009 absence of P waves in an bivalirudin. 3. Diagnostica Stago, Inc. Press Release electrocardiogram. When AF is October 1, 2010 experienced, the risk of stroke Studies on Pradaxa ® indicate that this 4. Venous Disease Coalition following abnormal blood clot new oral anticoagulant has a rapid formation is greatly increased, onset and predictable anticoagulation resulting from this abnormal heart action. There is also no evidence to activity. Risk of AF increases with suggest it interacts with food, while its The new oral anticoagulant, age. potential to interact with other drugs is Pradaxa® (Dabigatran considered low. Warfarin has been in use for over 50 etexilate), developed by years, and continues to be the The Ecarin Chromogenic Assay Boehringer Ingelheim. standard oral anticoagulant. It does, (ECA) from Diagnostica Stago, however, have drawbacks. (Stago), is a highly-specific tool for Thromboprophylaxis with warfarin is determining the exact direct thrombin influenced by genetic differences in inhibitor (DTI) concentration in metabolism, concurrent medication plasma without interference from The ECA reagents and consumables use, vitamin K intake, drug abnormal prothrombin or fibrinogen are available from Diagnostica Stago interactions, and alcohol levels. ANZ. consumption among others. To keep ECA results are independent of patients within the INR target range, coagulation factors and plasmatic Email [email protected] regular monitoring and dosage inhibitors within the sample; and as it fax +61 3 9855 8999 or adjustments are needed. Warfarin is is not influenced by lupus phone 1800 4 78246 Australia used for therapy of AF as well as anticoagulants, the assay allows for 0508 4 78246 New Zealand veneous thromboembolism (VTE) specific determinations. ECA is and pulmonary embolism (PE), insensitive to heparin, LMWH, though the recommended danaparoid, fondaparinux and direct therapeutic ranges are different factor Xa antagonists. This facilitates depending on the disease state bridging and transition to other being treated. anticoagulants, and dosage The search for alternative orally adaptation in highrisk patients. administered drugs led to the Additionally, the ECA dose response development of Pradaxa ® results are linear and do not plateau

(dabigatran etexilate). Pradaxa ® is at elevated concentrations. The ECA an oral direct thrombin inhibitor that kit is CE marked and available for use was discovered and developed by in diagnostic procedures. Boehringer Ingelheim. It is the first new oral anticoagulant approved in the U.S. in more than 50 years, and was approved for the treatment of

6 Changing lot numbers ––– Easy to use instruction sheets now available

Changing reagent and quality on the analyser may prevent a lot of control lot numbers is an inevitable angst! occurrence, but it can be a bit of an intimidating process for lab staff who don’t have to do it regularly, or Help Sheets are available for both those unfortunate enough to have Stago and non-Stago reagents and to do it at night or on weekends. Quality Control for all routine tests (PT, APTT, Fib, TCT and ATIII).

To help you with this Stago have created a series of “Help Sheets”. If you would like a copy of the Help These are step by step, analyser Sheets for your lab please email specific instructions directing you [email protected] with details of how to go about loading a new lot of which tests and what reagent / QC reagent or QC, calibrate it, put in you use, or speak to your local Technical QC reference ranges and finally run Applications Specialist. your tests. Having these easily accessible to staff who are working Information

Cap changes to the Heparin product line

In order to improve the ease of use, 00355) => reagent 1 : white, reagent 2 : the colour of the caps will be modi- blue fied for the following products:

The first product to be modified is the - STA Quality HNF (code 00381) => rea- STA Quality HBPM/LMWH code 00686 gent 1 : white, reagent 2 : blue batch 107224

- STA Quality HBPM (code 00686) => Other products will follow and we will reagent 1 : white, reagent 2 : blue keep you informed.

- STA MulHep Calibrator (code 00348) => reagent 1 : white, reagent 2 & 4 : blue, reagent 3 & 5 : red - STA Fondaparinux Control (code

7 Dates to Remember

October 29, 2011 Educaonal Website ASTH Scientific Workshop 2011

Darling Harbour Convention Centre, Sydney http://www.asth.org.au 24 hours per day 7 days per week Welcome to Stago-EdVantage.com

October 30 - November 2, 2011 New science and the transfer of HAA October 2011 knowledge leads to new standards of care, beer paent outcomes and Annual Scientific Meeting of the HAA (HSANZ, ANZSBT and ASTH Annual Scientific improved quality of life for the Meeting, 2011) paents we serve. Darling Harbour Convention Centre, Sydney http://www.haa-ap2011.org/ Diagnosca Stago, has long been ______commied to providing educaonal support to haemostasis tesng October 28—31, 2012 laboratories. Our customers APSTH and HAA 2012 parcipate by providing feedback and program requests on specific Asian-Pacific Society on Thrombosis and Hemostasis and Annual Scientific Meeting of the HAA (HSANZ, ANZSBT and ASTH Annual Scientific topics that may aid them in the use Meeting, 2012) of our products or provide Melbourne Convention and Exhibition Centre Melbourne, Australia knowledge to beer serve as their Further details to follow instuon’s haemostasis resource.

______Australian and New Zealand 29 June – 4 July 2013 parcipants can achieve APACE and XXIV ISTH Congress with 59th Annual SSC Meeting 2013 CPD connuing educaon credits and cerficates by registering and Frits R. Rosendaal, President compleng the acvies on this site. Amsterdam, The Netherlands Further details to follow Please visit:

hp://www.stago-edvantage.com/

Diagnostica Stago Pty. Ltd. 651 Doncaster Road Doncaster, VIC, 3108 Australia Phone (AUS): 1800 4 STAGO Phone (NZ): 0508 4 STAGO AUSTRALIAAUSTRALIA————NEWNEW ZEALAND Fax: +61 3 9855 8999 At the Heart of Haemostasis [email protected] www.stago.com.au