Blood Count Values Research Articles

Single-step preparation and image-based counting of minute volumes of human blood.

Current flow-based blood counting devices require significant medical infrastructure and are not appropriate for field use. In this article we report on the development of a sample preparation, measurement, and analysis method that permits automated and accurate counting of red blood cells (RBCs), white blood cells (WBCs), and platelets, as well as allowing a 3-part differential of the WBCs to be performed on extremely small volumes of whole blood. This method is compatible with portable instrumentation that can be deployed in the field. The method consists of serially diluting blood samples first with sodium dodecyl sulfate dissolved in phosphate buffered saline, then in acridine orange dissolved in phosphate buffered saline, followed by fluorescence and dark field imaging with low magnification objectives. Image analysis is performed to extract cell counts and differentials. We performed a paired analysis of 20 volunteers with complete blood count values both within and beyond the normal reference range using a commercial automated hematology analyzer and the image-based method, with the new method achieving accuracies comparable to that of the commercial system. Because the sample preparation and imaging are simple and inexpensive to implement, this method has applications for pediatrics, clinician offices, and global health in regions that do not have access to central hematology laboratories.

Increased I2-globulin Levels in Captive Oriental White Storks Fed a Diet of Sand Eels

The aim of the study was to identify the effects of two different diets (sand eels or saurels) on the serum protein electrophoretic patterns of Oriental White Storks held in captivity. The tests were performed on two groups of storks according to the diet (group 1 and 2). Twenty-two (group 1) or twenty-nine (group 2) storks were included. The values of complete blood count (CBC), serum biochemistry profiles, protein fractions (albumin, α-globulin, β-globulin, and γ-globulin), and lipoprotein (high density- [HDL] and low density lipoprotein [LDL]) were compared between samples obtained during two groups (p < 0.05). The α-globulin fraction was decreased and the β-globulin fraction was significantly increased in samples obtained from group 1 compared to those obtained from group 2. In group 1, the concentration of LDL was also significantly increased compared to that of group 2. In conclusion, we confirmed that the β-globulin fraction was significantly elevated in storks fed sand eels.

The Effect of Haematological Parameters on Overall Survival in Advanced Stage Non Small Cell Lung Cancer.

In this study, we aimed to evaluate the prognostic value of pretreatment blood count values, particularly WBC counts, in patients with advanced non-small cell lung cancer (NSCLC). The records of 186 patients with advanced stage (stage IIIB and IV) NSCLC were assessed retrospectively. Patients were divided into 3 subgroups according to WBC levels; ≤10000 /mm3 as Group 1, >10000 and ≤15000/mm3 as Group 2 and >15000/mm3 as Group 3. Patient and tumor characteristics as well as outcomes in terms of overall survival (OS) were evaluated. Median OS was 13.3 months in the whole population, 25.7 months in stage IIIB and 8.9 months in stage IV patients. According to the pretreatment leukocyte values, median OS was 17.9 months in Group 1, 11.2 months in Group 2 and 8.4 months in Group 3 (p= 0.003). Median OS values in WBC groups according to stages IIIB and IV were significantly different (p< 0.001). In multivariate analyses, ECOG-PS 2 or 3, stage IV disease, anemia and high WBC levels were associated with poorer OS. In this study, higher pretreatment WBC levels were associated with poorer OS in patients with advanced stage NSCLC. Pretreatment WBC counts may represent a simple prognostic factor and may aid in tailoring treatment in patients with advanced NSCLC.

Antipsikotik kullanımıyla tetiklenen nötropeni olgusunda tedaviye lityum eklenmesi

Addition of lithium therapy in a patient with persistent neutropenia triggered with antipsychotics Decrease in leukocyte count might be seen during the use of antipsychotic medications. In such cases, treatment can be stopped or changed and blood count values must be closely monitored. As in this case report, however, if changing the treatment doesn’t provide improvement in blood counts, lithium augmentation can be considered. The objective of this case report is to point out that the addition of lithium therapy may be beneficial in patients with persistent neutropenia related to typical and atypical antipsychotic drugs.

Capillarite purpurique chronique diffuse du petit enfant

Pigmented purpuric dermatosis (or Schamberg's disease) is characterized by chronic macular purpura and capillaritis. It is more common in young adult males and adolescents and is generally localized on the lower limbs. In this article, we report on five young children with generalized Schamberg's disease. Five children (aged 13 months to 5 years) were included in this retrospective study. Time to consultation delay ranged from 15 days to 1 year. All patients presented asymptomatic generalized macular purpura. Skin biopsies were performed in 4 cases and were characteristic. The results of coagulation tests and complete blood counts were within the normal range in all patients. The clinical course was chronic, with periods of improvement and worsening. No treatment was prescribed. Schamberg's disease is uncommon in childhood. Our observations suggest that this diagnosis is not exceptional. Clinical appearance, setting and normal blood count values are sufficient to enable a diagnosis to be made. The clinical course is generally chronic, and as yet no treatments have demonstrated efficacy.

Does Mean Platelet Volume in Children with Bronchiectasis Predict Exacerbations?

Bronchiectasis is a parenchymal lung disease which develops as a consequence of chronic inflammation and recurrent pulmonary infections. It is known that platelets have a role in inflammation and progressive pulmonary damage. Mean platelet volume (MPV) values as a marker of platelet activation, and might be used as an indicator of inflammation. Eighty-one children with the diagnosis of bronchiectasis followed between July 2010-July 2012 were enrolled in the study. The demographical data of patients were recorded and complete blood count (CBC) and MPV values were screened via hospital patient database. Complete blood count and MPV values were compared to age and sex-matched healthy children’s data. In addition, CBC and MPV values were compared among chronic disease period without any exacerbation and exacerbation period in the children with bronchiectasis. The study was consisted of 81 children with bronchiectasis and 79 healthy controls. There was no significant difference between MPV values of non-exacerbation period and control group (p>0,05). Mean platelet volumes during acute exacerbation were significantly lower when compared with the values of non-exacerbation period and controls (p= 0,02 and p= 0,01 respectively). MPV and platelet counts (r = -0,502, p= 0,01) as well as leucocyte count and hemoglobin levels were inversely correlated with each other in exacerbation period (r= -439, p= 0.00). Mean platelet volume measured at during acute exacerbation were significantly decreased in children with bronchiectasis. With the result of present study, we suggest that MPV might be used as a predictor marker for diagnosis of acute exacerbations in children with bronchiectasis.

Mean platelet volume (MPV): could it be used as a predictive marker for gestational diabetes?

An abnormal glucose tolerance which is first detected during pregnancy and disappears after completion of pregnancy is known as “gestational diabetes mellitus”. Early detection of this condition helps preventing potential maternal and fetal complications. Some studies reported that platelets may have a role in the pathogenesis and development of gestational diabetes. In the present study, we aimed to evaluate and compare the platelet function and morphology among pregnant women with gestational diabetes and healthy pregnant women. Values of complete blood count were reviewed for pregnant women between weeks 24 and 28 of gestation while performing oral glucose tolerance tests for from January 2013 to September 2013. After screening, a total of 89 pregnant women were enrolled in the study including 38 women with gestational diabetes and 51 healthy pregnant women. The mean platelet volume (MPV) was 8.76 ± 1.53 fl in the group with gestational diabetes and 7.80 ± 1.34 fl in the healthy pregnant group, with a statistically significant difference between two groups (p=0.02). There was no statistically significant difference between two groups in platelet counts (p=0.25). Dissimilar results were reported by a small number of studies on this subject. MPV and other platelet parameters may be considerably helpful in detecting diabetic pregnant women who are at risk for vascular complications. In this study, significantly greater MPV was found among pregnant women with gestational diabetes compared to control group (p

Evaluation of affecting factors for conversion to open cholecystectomy in acute cholecystitis.

IntroductionLaparoscopic cholecystectomy has become the gold standard for the surgical treatment of gallbladder disease. Severe inflammation makes laparoscopic dissection technically more demanding in acute cholecystitis. Conversion to open cholecystectomy due to adverse conditions is still required in some patients.AimTo evaluate predictive risk factors associated with conversion to open cholecystectomy in acute cholecystitis.Material and methodsA retrospective analysis was performed on 165 patients who underwent a laparoscopic cholecystectomy for acute cholecystitis in our clinic. Patients who completed laparoscopic cholecystectomy and required conversion to open cholecystectomy were compared in terms of age, sex, fever, laboratory and USG findings, operation timing, complications, and duration of hospital stay.ResultsThere were 53 (32%) male and 112 (68%) female patients; the mean age was 52.4 ±12.5 years. Forty-six (27.9%) of the 165 patients were converted to open cholecystectomy. Male sex of the patients who underwent conversion (47.1%) was found to be statistically significant (p < 0.001). Preoperative white blood count, blood glucose and amylase values, morbidity rate, and hospital stay were raised in patients who underwent conversion, and all were found to be statistically significant (p < 0.05).ConclusionsMale sex, blood leucocyte, glucose, and raised amylase emerged as the effective factors for conversion cholecystectomy in our study. These factors should help the clinical decision-making process when planning laparoscopic cholecystectomy in acute cholecystitis. By predicting these risk factors for conversion, preoperative patient counselling can be improved.

Hereditary spherocytosis: Consequences of delayed diagnosis.

Objective:To determine whether patients with undiagnosed hereditary spherocytosis hospitalized for transfusions might have avoided hospitalization via earlier diagnosis.Study design:Charts of all (N = 30) patients with hereditary spherocytosis seen in pediatric hematology at West Virginia University-Charleston were reviewed. Family and transfusion history and presence of neonatal jaundice were recorded. Complete blood count and reticulocyte values during infancy were available for 20 of 30 patients, while baseline steady-state values were available for all 30.Results:Transfusions were given to 22 patients; 12 of 14 with an aplastic crisis were undiagnosed. In 10 of 12, the severity of anemia led to hospitalization (3 to intensive care). All 10 had prior mean corpuscular hemoglobin concentration and/or red cell distribution width elevations and a history of neonatal jaundice; 7 of 10 had a positive family history.Conclusions:Undiagnosed hereditary spherocytosis may lead to inpatient transfusions for severe anemia. Earlier detection of hereditary spherocytosis is easily achievable and may reduce hospitalizations via closer monitoring.

Successful treatment of myelodysplastic syndrome and Behcet colitis after allogeneic hematopoietic stem cell transplantation

Successful treatment of myelodysplastic syndrome and Behcet colitis after allogeneic hematopoietic stem cell transplantation

Valores de referencia del hemograma completo en escolares de 8 a 12 años de edad residentes a 2.760 m sobre el nivel del mar

ObjectiveTo determine reference values for full blood count parameters in a population of children 8 to 12 years old, living at an altitude of 2760m above sea level. Material and methodsOur sample consisted of 102 individuals on whom a full blood count was performed. The parameters included: total number of red blood cells, platelets, white cells, and a differential count (millions/μl and %) of neutrophils, lymphocytes, monocytes, eosinophils and basophils. Additionally, we obtained values for hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, concentration of corpuscular hemoglobin and red blood cell distribution width. The results were statistically analyzed with a non-parametric test, to divide the sample in quartiles and obtain the lower and upper limits for our intervals. Moreover, the values for the intervals obtained from this analysis were compared to intervals obtained estimating+- 2 standard deviations above and below from our mean values. ResultsOur results showed significant differences compared to normal interval values reported for the adult Mexican population in most of the parameters studied. ConclusionsThe full blood count is an important laboratory test used routinely for the initial assessment of a patient. Values of full blood counts in healthy individuals vary according to gender, age and geographic location; therefore, each population should have its own reference values.

Is Zinc Concentration in Toxic Phase Plasma Related to Dengue Severity and Level of Transaminases?

ObjectiveTo determine the relationship between plasma zinc values and the severity of dengue viral infection (DVI) and DVI-caused hepatitis.MethodsA prospective cohort study was conducted during 2008–2010 in hospitalized children aged <15 years confirmed with DVI. Complete blood count, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and zinc values (mcg/dL) were determined twice: first during the toxic phase (Zn1) and secondly two weeks after recovery (Zn2).Results39 patients were enrolled with a mean age of 9.7±3.7 years, and 15/39 diagnosed with dengue shock syndrome (DSS). Zn1 values were lower than Zn2 values [median (IQR): 46.0 (37.0, 58.0) vs 65.0 (58.0, 81.0) mcg/dL, respectively, p <0.01]. Zn1 but not Zn2 values had a negative correlation with AST and ALT (rs = −0.33, p = 0.04 and rs = −0.31, p = 0.05, respectively). Patients with DSS had lower Zn1 but not Zn2 values compared with non-DSS patients [median (IQR) Zn1, 38.0 (30.0, 48.0) vs 52.5 (41.2, 58.7), p = 0.02; Zn2, 61.0 (56.0, 88.0) vs 65.0 (59.5, 77.5), respectively, p = 0.76]. Zn1 values showed a decreasing trend across increasing dengue severity groups (p = 0.02). Age <5 years and DVI-associated diarrhea were associated with low Zn1.ConclusionChildren who had a higher grade of dengue disease severity and liver cell injury had lower Zn1 values. Low Zn1 values were probably caused by loss from diarrhea and from zinc translocating to liver cells.

Prognostic Value of Complete Blood Count and Electrolyte Panel during Emergency Department Evaluation for Acute Ischemic Stroke

Objective. To determine whether routine laboratory parameters are predictors of early mortality after acute ischemic stroke (AIS). Methods. The cohort consisted of 522 consecutive patients with AIS presenting to the emergency department (ED) at a tertiary referral center during a 27-month period, residing within the surrounding ten counties. Serum laboratory values were obtained for all patients and categorized according to whether the levels were low, normal, or high. These laboratory results were evaluated as potential predictors of 90-day mortality using Cox proportional hazards models. The associations were summarized by calculating risk ratios (RRs) and 95% confidence intervals (CI). Results. The presence of elevated white blood cell count (RR 2.2, 95% CI 1.5–3.4), low bicarbonate (RR 4.2, 95% CI 2.6–6.7), low calcium (RR 2.9, 95% CI 1.4–5.9), and high glucose (RR 1.3, 95% 1.1–1.6) were each univariately associated with significantly higher mortality within the first 90 days. Based on fitting a multivariate Cox regression model, elevated white blood cell count, low bicarbonate, and high glucose were each identified as being jointly associated with early mortality (). Conclusion. Early leukocytosis, acidosis, and hyperglycemia and hypocalcemia in AIS appear to be associated with early mortality. Whether addressing these factors will impact survival remains to be investigated.

Correlation Between Cadmium and Blood Counts in Workers Exposed to Urban Stressor

The objective of this study was to assess the exposures to cadmium (Cd) in urban workers and the association between Cd exposure and values of blood counts. Urinary Cd, blood Cd, and blood counts were obtained from 355 outdoor workers; a subgroup of 99 subjects were monitored to evaluate personal exposure to airborne Cd. The mean value of personal exposure to Cd was 1.5 ng/m3 for traffic assistants and 1.2 ng/m3 for drivers. Urinary and blood Cd were correlated to the airborne Cd (respectively r =.3 and r =.4). The multiple linear regression models showed the associations among white blood cell, the percentage of neutrophils (NEU%), the percentage of lymphocytes (LYM%), and the concentrations of blood Cd (respectively R2 =.27, R2 =.37, R2 =.581). The subjects with blood Cd values higher than 1.2 μg/L showed an increase of LYM% mean values and a decrease of NEU% mean values with respect to the group with blood Cd values lower than 1.1 μg/L.

Association between Helicobacter pylori and liver-to-spleen ratio

Helicobacter pylori infection is reported to be associated with some extragastrointestinal manifestations, such as hematological diseases (thrombocytopenia, anemia), obesity, and fatty liver disease. The length or the volume ratio of liver to spleen was suggested to be changed in some hematological and hepatobiliary disorders. We hypothesized that the liver-to-spleen ratio may be affected in H. pylori-positive patients. In this respect, we aimed to evaluate the effect of H. pylori infection on the liver-to-spleen ratio and platelet indices. A total of 174 patients with functional dyspepsia were included in the study. Patients were divided into group 1 (H. pylori-positive gastritis) (n=95) and group 2 (H. pylori negative, control group) (n=79). Liver, spleen length measurement, and liver steatosis scores were performed by ultrasonography by the same physicians who were blinded to the H. pylori results. Blood count values including the platelet count and the mean platelet volume (MPV) were compared between the two groups. BMI was also evaluated as a potential confounding factor for fatty liver. The liver-to-spleen ratio, platelet-to-spleen ratio, MPV-to-spleen ratio, and the MPV-to-liver ratio were significantly lower in the H. pylori-positive group compared with the H. pylori-negative group (P<0.001, <0.001, <0.001, and 0.038, respectively). Fatty liver was significantly more frequent in H. pylori-positive patients. Liver-to-spleen ratio and the MPV-to-spleen ratio are important indices in the pathogenesis of H. pylori-linked liver and spleen manifestations, and thrombocytopenia.

Assessment of Bacterial Vaginosis Incidence and Neonatal Outcome on Cases with Preterm Premature Rupture of Membranes

SUMMARY Objective: The effect of bacterial vaginosis on cases with preterm premature rupture of membranes (PPROM) was searched via screening for bacterial vaginosis (BV) in cases with PPROM and healthy pregnant women during same gestational weeks. Material and method: The study incorporated 121 patients who applied to obstetrics poly-clinics at our hospital. Detailed medical histories were obtained from all patients, prior to vaginal examination by sterile speculum. Vaginal samples were taken for analysis via Nugent scoring system. Through verbal scoring, the symptoms due to vaginitis, namely, vaginal discharge, vaginal burning, pruritis, dysuria and malodor were recorded. With regard to pre- and postnatal periods, age, gestational week, complete blood count values, history of gravida, parity and abortion, history of PPROM and duration, gestational week at the time of delivery, mode of delivery of the cases and maternal morbidity were evaluated. All participants were asked to grant informed consents. The study was held under approval by Ethics Committee of the Hospital. Results: The study incorporated 72 cases of pregnant women with PPROM as study group, and 49 cases of healthy pregnant women as control group. No statistically significant difference was determined in terms of average age, gravida and parity values. Nugent scoring system revealed bacterial vaginosis in 75 cases (75/121; 61.9%) in total: 43 in PPROM study group (43/72; 35.5 %) and 32 in control groups (32/49; 26.4%). Statistically, BV was determined at a higher ratio in PPROM study group; similarly, vaginal delivery ratio was higher and APGAR scores of neonates at 1st and 5th minutes were lower in PPROM study group, compared to control group (p<0.05). Conclusion: Bacterial vaginosis is a frequently detected infectious disease for pregnant women. It can be considered as an important factor in etiology of PPROM and perinatal morbidity.

Validation of reportable indices of haematology, liver and renal function in pregnancy for the Middle Eastern population

The objective of this study was to describe normative values of complete blood counts, kidney and liver function tests for Jordanian women. A prospective study of 797 healthy pregnant women, seen at the antenatal clinics of the Jordan University of Science and Technology, in Irbid, north Jordan, was conducted between January 2005 and December 2009. Differences by trimester were analysed using one-way ANOVA. The mean age of the women was 31.0 years. The mean gestational age at delivery was 38.2 weeks. It was concluded that complete blood counts, kidney and liver function values by trimester, of healthy pregnant population of Jordanian women, were consistent with data reported for other populations.

A New Hemoglobin Variant: Hb Izmir [β86(F2)Ala→Val, GCC>GTC; HBB:c.260C>T

We report a new hemoglobin (Hb) variant [β86(F2)Ala→Val; HBB:c.260C>T] that we have named Hb Izmir. We have identified Hb Izmir in a Turkish woman by ion exchange high performance liquid chromatography (HPLC) during a premarital screening program in the Aegean region of Turkey. The mother and sister of the proband also carried the same variant. Using direct sequencing, we have characterized this variant as resulting from a GCC>GTC replacement at codon 86 of the β-globin chain, corresponding to an Ala→Val amino acid substitution. In the heterozygote, the level of Hb Izmir ranged from 41.38 to 45.6%. All heterozygotes had a Hb A2 level of less than 3.5%. Total blood count values were normal and there were no other clinical findings. Although its clinical significance is thus far unclear, Hb Izmir may be important in hemoglobinopathy screening programs.

Asymptomatic cerebral bleeds in patients with aplastic anemia

Several studies suggest that cerebral microbleeds (CMB) seen on gradient echo magnetic resonance imaging (GE-MRI) of brain increase the future risk of intracranial hemorrhage (ICH). We investigated 26 newly diagnosed patients of aplastic anemia (AA) with GE-MRI of brain who were otherwise neurologically asymptomatic. These patients were then further followed up for a period of 6 months for development of overt ICH. The median age of patients was 20.5 years (range 12-40 years). The median values of complete blood counts at the time of diagnosis were hemoglobin 5.7 gm/dl (range 2.5-9.2 gm/dl), white cell count 2,320/μl (800-7,000/μl), and platelet count 11,500/μl (7000-45,000/μl). Three patients were detected to have CMB while two patients had asymptomatic cerebral macrobleeds (>1 cm). During the follow-up period of 6 months, two patients developed spontaneous ICH. None of the two patients had CMB at diagnosis. In conclusion, asymptomatic CMB were found in 11.5 % of patients with AA. The overall prevalence of asymptomatic ICH (CMB & macrobleeds) was 19.2 %. Further studies with larger number of patients are required to clearly delineate the association.

Null-Type Anaplastic Lymphoma Kinase–Negative Anaplastic Large Cell Lymphoma Arising in a Silicone Breast Implant Capsule

Null-Type Anaplastic Lymphoma Kinase–Negative Anaplastic Large Cell Lymphoma Arising in a Silicone Breast Implant Capsule