Erythrocyte Sedimentation Rate Analysis Research Articles

Comparative study of erythrocyte sedimentation rate measurement between Celltac Alpha+ (MEK-1305) ESR Analyzer and standard Westergren method

Background: The Westergren method, a gold standard method for erythrocyte sedimentation rate (ESR) measurement, is one of the screening tests for routine clinical hematology that can be used as an inflammation marker. Since the results can be altered by numerous factors, new methodologies have been established to manage the possible pitfalls. Objective: This study compared erythrocyte sedimentation rate measurements obtained by the Celltac Alpha+ (MEK-1305) Automated Hematology and ESR analyzer with those obtained by the standard Westergren method. Materials and methods: The Celltac Alpha+ (MEK-1305) Automated Hematology and ESR analyzer was used to assess the performance of ESR measurement compared to the standard Westergren method. A total of 220 random EDTA whole blood samples from patients were included and analyzed in parallel using the automated analyzer and the standard Westergren method. Results: Spearman’s rank correlation coefficient (ρ = 0.916) obtained a good correlation between the two methods. In addition, the precision was good and acceptable according to the criteria, with a %CV of less than 10% in both intra-run and inter-run precision. There was no contamination between blood samples from using a single capillary probe. Moreover, Bland-Altman mean difference plot also indicated a good agreement, with a mean bias of -1.4 (95% CI: -0.8 to 2.1), an upper LOA of 7.6 (95% CI: 6.6 to 8.7) and a lower LOA = -10.5 (95% CI: -11.6 to -9.5). Conclusion: This comparative study indicated that the Celltac Alpha+ (MEK-1305) Automated Hematology and ESR analyzer is applicable within clinical routine practice along with proper measurement regulation. Even though the principles between these two methods are completely different, an acceptable interrelation was obtained due to the calibration process by Nihon Kohden corporation.

A-137 Performance Evaluation of an Automatic, Rapid and Non-Westergren Based Method for Erythrocyte Sedimentation Rate Measurement

Abstract The erythrocyte sedimentation rate (ESR) is widely used for the assessment of acute or chronic inflammation, especially for rheumatoid diseases. The gold standard for determining ESR is the Westergren method, which measures the distance in millimeters that red blood cells fall in one hour. However, this method needs to be performed manually, which increases the biohazard risk to laboratory personnel, and the results are often influenced by many preanalytical and analytical factors. Several automated ESR analyzers with different methodologies are now available to provide faster results directly from whole blood anticoagulated with K3EDTA. In this study, we evaluated the performance of an automatic ESR analyzer, Alifax TEST1, and compared it with that of another automatic analyzer, Diesse Cube 30 touch, and also the Westergren method. TEST1 extrapolates the ESR values by measuring the kinetics of red cells aggregation in 20 s, while Cube 30 is a modified Westergren method that could obtain the results in 20 min. A total of 75 clinical samples were analyzed for ESR using the three methods. The hematocrit (Hct) and C-reactive protein (CRP) values were also analyzed. The Spearman correlation coefficient between TEST1 and Westergren methods was 0.90 (P < 0.0001) with a mean difference of -5.45; the correlation between Cube 30 and Westergren methods was 0.80 (P < 0.0001) with a mean difference of 10.74; the correlation between TEST1 and Cube 30 was 0.69 (P < 0.0001) with a mean difference of -15.9. The precision values (CV %) of TEST1 in low-, medium- and high-level controls were 2.71%, 1.21% and 1.05% for inter-assay, and 3.70%, 1.66% and 0.86% for intra-assay. The normal range of TEST1 was also established by analyzing ESR values of 125 healthy individuals where it is 0–15 mm/hr for men ≤50years old, 0–20 mm/hr for men > 50 years old and for women ≤50 years old, and 0–30 mm/hr for women > 50years old. The ESR values obtained from the three methods all significantly correlated with plasma CRP levels. However, the ESR values from Cube 30 and Westergren methods negatively correlated with Hct values, while that from TEST1 did not. The present study demonstrates that 1) TEST1 has a better correlation and a lower difference to the Westergren method compared to Cube 30, suggesting that TEST1, the automatic, rapid and non-Westergren based method is an effective assay for clinical practice; 2) the Westergren based methods are more easily influenced by Hct; 3) the large mean difference between TEST1 and Cube 30 highlights a need for harmonization of the ESR values obtained from different automatic analyzers, especially when it is applied to monitor the disease activity score (DAS28) in rheumatoid arthritis patients.

Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) in COVID-19 patients at the RSPTN UNHAS, Makassar

Coronavirus Disease-19 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) as part of the novel coronavirus. Clinical monitoring and appropriate treatment strategies are essential to reduce case fatality. Various examination parameters to support diagnosis such as ESR and CRP in assessing the response of a systemic inflammatory process. C-reactive protein (CRP) levels can be used in the initial diagnosis of pneumonia and patients with severe pneumonia have high CRP levels. Erythrocyte Sedimentation Rate (ESR) as a non-specific inflammatory response examination which has increased in various physiological disorders such as infection and inflammation. The purpose of this study was to determine the levels of ESR and CRP as biomarkers of inflammation in patients with COVID-19 at RSPTN UNHAS, Makassar. This study involved 32 subjects who met the inclusion criteria for positive RT-PCR COVID-19, age 21-70 years and signed of informed concent. Erythrocyte Sedimentation Rate Check by Auto ESR Analyzer using the Westergreen method and C-reactive protein Check by qualitative test. The result of this research that the average age of the subjects was 51 years consisting of 14 (56.2%) female subjects and 18 (43.8%) male subjects. The median value of CRP examination is 48.00 mg/dL and the median value of ESR is 63.00 mm/hour. 2. There is a significant difference between the CRP values in male and female subjects. There is a significant relationship between CRP and ESR values with a strong

Serum levels of soluble urokinase plasminogen activator receptor in juvenile idiopathic arthritis: a single-center Swedish case-control study

ObjectivesReliable biomarkers in the early stages of idiopathic arthritis (JIA) are scarce and the disease heterogeneity makes it clinically challenging to predict the risk of joint damage. Biomarkers with prognostic potential are warranted in order to individualize treatment and follow-up in JIA. The soluble urokinase plasminogen activator receptor (suPAR) has been reported as an easily measurable biomarker for prognosis and severity in several rheumatic diseases but it has never been studied in JIA.MethodsSera from 51 well-characterized patients with JIA and 50 age- and sex-matched control subjects were collected and stored for later analysis of suPAR. Patients were carefully followed clinically over 3 years and analysis of erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor (RF) and antibodies against cyclic citrullinated peptides (anti-CCP) were analyzed as part of clinical routine. Signs of joint erosions were evaluated by radiography.ResultsOverall, the levels of suPAR did not differ significantly between JIA patients and controls but those with polyarticular involvement showed higher suPAR (p = 0.013). In addition, elevated suPAR were associated with joint erosions (p = 0.026). Two RF/anti-CCP negative individuals with erosions showed high levels of suPAR.ConclusionsWe present new data on the biomarker suPAR in JIA. Our results indicate that, apart from RF and anti-CCP, analysis of suPAR could be of additional value in assessing the risk of erosions. Analysis of suPAR early could potentially guide treatment decision-making in JIA, but our observations should be confirmed in prospective studies.

A Comparative Study on Determination of Erythrocyte Sedimentation Rate by Two Automated Erythrocyte Sedimentation Rate Analysis Techniques-Ves Matic Cube 30 and Mixrate X20 in Comparison to Modified Manual Westergren Method

BACKGROUND: Erythrocyte sedimentation rate (ESR) is a widely used simple and cost-efficient lab test for the diagnosis and follow-up of many diseases. Even though the Westergren method is considered as gold standard, it has many drawbacks such as long test time duration, infection risk to technician, and need of citrated blood sample and to overcome these limitations, automated ESR analysis techniques have been introduced. This study aimed to compare and assess the agreement as well as to analyze the correlation between the ESR values obtained by two automated ESR analysis techniques– Ves Matic Cube 30 and Mixrate-X20 against the gold standard–Modified Manual Westergren method. MATERIALS AND METHODS: Four milliliter blood samples were collected from 1174 patients who came to the Central laboratory with complete blood count and ESR test request forms, after taking informed consent. Each of these samples was subjected to ESR test in both Mixrate X20 and Ves Matic Cube 30, followed by ESR analysis through the modified manual Westergren method. All values obtained were recorded and analyzed using SPSS software. Mean, standard deviation, Bland–Altman agreement analysis, Linear regression, and Pearson's correlation coefficient analysis was done. RESULTS: Of 1174 study samples, 588 were male and 586 were female and major proportion of the study sample was in the age group of 50–59 years. Bland–Altman agreement analysis of manual ESR Vs Ves Matic cube 30, showed a mean difference of −2.44 ± 13.01 with 95% limit of agreement (LOA) between −27.93 and 23.05 whereas it was 0.05 ± 1.68 with 95% LOA between −3.24 and 3.34 for manual ESR vs Mixrate X20. Pearson's correlation coefficient for manual ESR Vs Ves Matic Cube 30 was r = 0.891 whereas r = 0.998 for manual ESR Vs Mixrate X20, indicating a strong positive correlation between ESR values obtained through manual method and both automated ESR analyzers. CONCLUSION: ESR results from both automated analyzers are agreeable to the reference method with no proportional bias statistically. However, the results from Mixrate X20 ESR analyzer correlate very well with the manual ESR, with close readings that do not affect the clinical interpretation and so can be used in clinical laboratories to optimize workflow and use of human resources.

Impact of fixed orthodontic appliances on blood count and high-sensitivity C-reactive protein levels: A prospective cohort study

The aim was to elucidate the magnitude of alterations in systemic blood counts in healthy patients during the first 14 days after fixed orthodontic appliance placement. This prospective cohort study consecutively included 35 White Caucasian patients starting orthodontic treatment with fixed appliances. The mean age was 24.48 ± 6.68 years. All patients were physically and periodontally healthy. Blood samples were collected at 3 time points: (1) baseline (exactly before the placement of appliances), (2) 5 days after bonding, and (3) 14 days after baseline. Whole blood and erythrocyte sedimentation rates were analyzed in automated hematology and erythrocyte sedimentation rate analyzer. Serum high-sensitivity C-reactive protein levels were measured by the nephelometric method. Standardized sample handling and patient preparation procedures were adopted to reduce preanalytical variability. A total of 105 samples were analyzed. All clinical and orthodontic procedures were performed without complications or side effects during the study period. All laboratory procedures were performed per protocol. Significantly lower white blood cell counts were detected 5 days after bracket bonding, compared with baseline (P<0.05). Hemoglobin levels were lower at 14 days than baseline (P<0.05). No other significant shifts or alteration patterns were observed over time. Orthodontic fixed appliances led to a limited and transient change in white blood cell counts and hemoglobin levels during the first days after bracket placement. The fluctuation of high-sensitivity C-reactive protein levels was not significant, demonstrating a lack of association between systemic inflammation and orthodontic treatment.

Evaluation of the ESR fast detector and Improve® ESR analyzer as modified Westergren methods for erythrocyte sedimentation rate

The erythrocyte sedimentation rate (ESR) has been commonly ordered in hematology laboratories and used to screen for monitoring responses to therapy and identifying inflammatory conditions. To overcome the limitations of traditional ESR measurements, various methods have been developed and compared to the established reference method. This study evaluates the analytical performance of ESR fast detector and Improve® ESR analyzer compared to the reference method. Method validation and comparison were performed in 189 volunteer blood samples according to the International Council for Standardization in Hematology recommendations. The analytical efficacy of ESR fast detector and Improve® ESR analyzer was also assessed and compared with the reference method and C-reactive protein (CRP) levels. The results demonstrated that the precision of ESR fast detector and Improve® ESR analyzer was considered as the acceptance criterion for the ESR measurement. The method comparison analysis between the two modified Westergren methods and reference method demonstrated a strong correlation with the Spearman’s rank correlation coefficient of 0.94, with a mean difference of −2.1 and −7.7 mm/h in the ESR fast detector and Improve® ESR analyzer, respectively. Analysis of the area under the receiver operating curve illustrated a high analytical performance compared to the reference method and CRP level. The measurement of ESR level using the ESR fast detector and Improve® ESR analyzer is a reliable method and has a high analytical performance, which can be used instead of the reference method for screening inflammatory conditions.

Method Verification of the Caretium XC-A30 Automated Erythrocyte Sedimentation Rate Analyser for Erythrocyte Sedimentation Rate.

The erythrocyte sedimentation rate (ESR) analyser is widely used in haematological testing. In addition to the Westergren method, new automatic methods for ESR measurements have been developed. We aimed to study the reliability, precision, accuracy and stability of the Caretium XC-A30 automated ESR analyser. Ethylenediamine tetraacetic acid (EDTA)-treated blood samples were analysed via the Caretium XC-A30 automated ESR analyser and the Westergren method to compare accuracy. Precision was assessed using control samples and patient samples were classified into three groups-low, medium and high-according to their rates of sedimentation. Moreover, a stability test was performed. The correlation coefficient of the results of the Caretium XC-A30 and Westergren analyses was 0.97. The correlation coefficient of ESR values obtained from the two methods assessed in the low, medium and high groups were r = 0.80, r = 0.68 and r = 0.74, respectively. The coefficient of variation of within-run (%CVw) and between-run (%CVb), with replicates performed with commercial controls samples, were 7.54% and 8.04% for the normal control and 4.68% and 3.50% for abnormal control, respectively. The %CVw obtained with patient samples in the low, medium and high groups were 10.68%, 13.13% and 4.45%, respectively. The Caretium XC-A30 measurements were stable for up to 24 h when samples were stored at 4 °C. The Caretium XC-A30 ESR analyser proved to be a suitable instrument for routine analysis of ESR.

Performance evaluation of the BC-720 auto hematology analyzer and establishment of the reference intervals of erythrocyte sedimentation rate in healthy adults.

BackgroundErythrocyte sedimentation rate (ESR) is a new reporting parameter of the BC-720 auto hematology analyzer; however, no biological reference interval for healthy adults has been established for this parameter.MethodsOutpatients or hospitalized patients with ESR test orders were selected. The ESR was measured by the standard method of ESR (Westergren) recommended by the International Council for Standardization in Hematology (ICSH), the BC-720 hematology analyzer, and the LBY-XC40B auto ESR analyzer. The data were statistically analyzed and compared among different methods. The repeatability and carryover rate (CR) of the BC-720 were assessed in randomly selected samples for each range segment. Blood Samples from three hospitals in China were collected, and the reference interval of the BC-720 ESR was determined.ResultsThe ESR results measured by the BC-720 correlated well with the Westergren method (r=0.957, y = 0.359 + 1.016x), and there was no significant difference between these two methods (P>0.05). The correlation between LBY-XC40B auto ESR analyzer and Westergren was y = 1 + 1.25x and r=0.856. The BC-720 ESR has good repeatability [standard deviation (SD) ≤1 mm/h, coefficient of variation (CV) ≤5%], and the CR was less than 1%. The 95th percentile of the biological reference interval for BC-720 ESR is 15 mm/h for men and 24 mm/h for women.ConclusionsThe Mindray BC-720 ESR showed high accuracy and good repeatability, which provided a faster, safer, and more reliable method to measure ESR. The reference intervals for BC-720 ESR could guide better clinical decisions for the laboratories utilizing this new method.

Osteoporosis in patients with rheumatoid arthritis is associated with serum immune regulatory cellular factors.

Osteoporosis (OP) is a comorbidity of rheumatoid arthritis (RA) that largely causes disability. This study discussed the expression patterns of serum immunoregulatory factors and their clinical significance in RA patients complicated with OP. A total of 116 RA patients were enrolled. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry to allocate patients to OP group (N = 62) and non-OP group (N = 54). CRP, rheumatoid factor, IgG, IgA, and IgM were detected using rate nephelometry. Erythrocyte sedimentation rate (ESR) and bone metabolic indexes were detected using Microsed automatic ESR analyzer and Cobas e601 automated immunoassay systems and reagents. IL-17, IL-6, TNF-α, IL-10, and IL-4 levels were determined using ELISA kit and their prediction values on OP were analyzed using the ROC curve. Influencing factors of OP incidence were analyzed using logistic regression model. RA patients with OP showed increased age, disease course, tender and swollen joints, ESR, CRP, DAS28 scores, β-CTX, IL-17, IL-6, and TNF-α, and decreased 25(OH)D3, IL-10, and IL-4. DAS28 was positively correlated with IL-17, IL-6, and TNF-α, and negatively correlated with IL-10 and IL-4. DAS28, IL-17, IL-10, and IL-4 were independently correlated with OP in RA patients. The combination of DAS28, IL-17, IL-10, and IL-4 can better predict the incidence of OP complication in RA patients. IL-17, IL-6, TNF-α, IL-10, and IL-4 were associated with disease activity of RA patients complicated with OP. A combination of DAS28, IL-17, IL-10, and IL-4 might predict OP incidence in RA patients.

Immunogenicity of Inactivated SARS-CoV-2 Vaccines in Patients With Rheumatoid Arthritis: A Case Series.

ObjectivesAttenuated humoral response to mRNA SARS-CoV-2 vaccines has been reported in some patients with autoimmune disease, e.g., rheumatoid arthritis (RA). However, data of immune responses to inactivated SARS-CoV-2 vaccine in the RA population are still unknown. Herein, the safety and immunogenicity of inactivated SARS-CoV-2 vaccines in RA patients were analyzed.MethodsSeventy five RA patients and 26 healthy controls (HC) were respectively recruited from Yunnan Provincial Hospital of Traditional Chinese Medicine and the community in Kunming city. Neutralizing Antibody (NAb) Test ELISA kit was used to measure the percentage of inhibition. AKA (anti-keratin antibody) positivity was detected using indirect immunofluorescence. Rheumatoid factor (RF)-IgA was detected by ELISA. RF-IgG, RF-IgM, and anti-cyclic citrullinated peptide (CCP) antibodies were measured by chemiluminescence. ESR (erythrocyte sedimentation rate) was detected by ESR analyzer. C-RP (c-reactive protein) was detected by immunoturbidimetry. NEUT% (percentage of neutrophils) and LYMPH% (percentage of percentage) were calculated by a calculation method.ResultsCompared with the HC group, the percentage of inhibition was significantly lower in RA patients receiving two doses of vaccines. Vaccines-induced percentage of inhibition was the lowest in RA patients who had not been vaccinated. In total 80.77% of the HC group had a percentage of inhibition ≧20%, compared with 45.24% of vaccinated RA patients and 6.06% of unvaccinated RA patients. Spearman correlation analysis revealed that antibody responses to SARS-CoV-2 did not differ between RA patients according to their age and disease duration. Furthermore, the results showed that no correlation was found between the percentage of inhibition and indices for RA, including RF-IgA, IgG, IgM; anti-CCP antibody; ESR; C-RP; NEUT% and LYMPH%.ConclusionOur study showed inactivated vaccine-induced SARS-COV-2 antibody responses differ in RA patients and healthy subjects, emphasizing the importance of a third or fourth vaccination in RA patients.

Establishment and Evaluation of an Internal Quality Control Method for ESR Relays.

ObjectiveThis study establish and evaluate an internal quality control system for erythrocyte sedimentation rate (ESR) by a “relay” mode based on samples from relevant patients.MethodsThe method for establishing a new internal quality control system for ESR by a “relay” mode based on patient’s samples was executed from February 2021 to July 2021. In this paper, a total of 219 outpatients were recruited for ESR determination, and their blood samples were stored at 4 °C or room temperature for 24 h. Subsequently, the samples were re-measured for ESR, and the re-measured values were compared with the initial values. The patient samples (15±1mm/h and 50±3mm/h) were selected after the TEST1 ESR analyzer was calibrated, and were stored overnight at 4 °C and measured again the following day. The percentage deviation was determined and entered into the quality control management module for internal quality control. Next, we analyzed the median distribution trend of the patients’ ESR values measured by our laboratory every day over five months, as well as the external quality assessment (EQA) results for ESR obtained from the National Center for Clinical Laboratories (NCCL).ResultsThe ESR of the room temperature samples after 24 h of storage had significantly decreased (P=0.001), while there was no noticeable difference for those stored at 4 °C (P=0.197). Results of the internal quality control in March were satisfactory, and there was no significant deviation in the median ESR relay results within five months. Besides, the EQA results for the ESR data obtained from NCCL were excellent.ConclusionAs a precise and practical new method, the ESR relay internal quality control method can be used to scientifically determine the stability and accuracy of the TEST1 ESR analyzer.

Evaluation of the Diesse Cube 30 touch erythrocyte sedimentation method in comparison with Alifax test 1 and the manual Westergren gold standard method

The erythrocyte sedimentation rate (ESR) is a traditional nonspecific laboratory test used for the assessment of inflammation. Even if its usefulness is nowadays being largely debated, it is still considered a valuable laboratory test in selected clinical conditions, such as rheumatoid diseases, orthopedic infections and Hodgkin’s lymphoma, and it can be used for the infectious, inflammatory, malignancies, and autoimmune diseases follow-up. The introduction of new methodologies on semi-automated and automated analyzers started about four decades ago and opened a new era of ESR analysis characterized by shorter assay time, use of (EDTA) undiluted blood, that increases sample stability and allows using a single sample for also other hematologic tests, and greater safety for laboratory personnel. In this context, the aim of this study was to evaluate the performances of new device Diesse Cube 30 touch, comparing it with Alifax Test 1 and with the gold standard Westergren method. The new Diesse Cube 30 touch for determination of the ESR shows a good correlation with the manual Westergren gold standard method in a shorter time, and in a standardized way, since all the phases of the test are automatized. The Diesse Cube 30 touch respect the manual gold standard method, displayed a small bias to confirm that the new automated test system tended to have a small bias for ESR values (mean positive bias +0.2 mm/h). The findings of the present study show that the Diesse Cube 30 touch Westergren-based method can be a valid alternative in laboratory analysis for the determination of ESR.

Evaluation of the Vision C erythrocyte sedimentation rate analyzer

Evaluation of the Vision C erythrocyte sedimentation rate analyzer

Comparative Analysis of Erythrocyte Sedimentation Rate Measured by Automated and Manual Methods in Anaemic Patients.

Purpose Erythrocyte sedimentation rate (ESR) is a widely used indicator of inflammation and a routinely done hematology investigation to monitor patients of autoimmune and infectious diseases. We aimed to compare the ESR results obtained by Roller 20LC automated instrument and standard reference Westergren method and analyzed the effect of anemia (hematocrit) on ESR measurements through the automated method. Methods We analyzed 1377 random anemic OPD patients (hematocrit [HCT] < 35%) for ESR levels measured by Roller 20LC using EDTA blood and Westergren method using citrated blood for a one and half year period from January 1, 2018 to June 30, 2019. Fabry’s formula was used to correct the Westergren ESR. Results The total number of samples after evaluation were divided into low ( n = 232), intermediate ( n = 417), high ( n = 406), and very high range of ESR (≥100 mm/hr; n = 422). Mean difference between values of corrected and automated ESR for the low, intermediate, high and very high ESR range was 2.33 ± 5.03, 10.95 ± 8.04, 28.22 ± 19.11 and 43.3 ± 19.22 mm/hr, respectively. The 95% limit of agreement calculated by the Bland–Altmann analysis between the two methods for low-ESR range was −7.53 to 12.2 (highest correlation coefficient –0.65), while for very high ESR, range was −5.1 to 81.5 (least coefficient of 0.18) ( p < 0.001). Conclusion In laboratories with high-sample load and where manual measurement may be tedious, the automated method of ESR measurement can safely replace the Westergren method for low-ESR values in patients with low hematocrit. While for high-ESR values, validation by the standard Westergren method may be needed.

Utility of Common Biomarkers for Diagnosing Infection in Nonunion.

To evaluate the diagnostic utility of leukocyte count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) for distinguishing between septic and aseptic nonunions. A single-gate (cohort) design was used, using 1 set of eligibility criteria applied to a consecutive sample of nonunions. Private quaternary referral center. Inclusion criteria were consecutive patients (≥18 years) with a nonunion requiring surgery that allowed for direct or medullary canal tissue sampling from the nonunion site. The cohort included 204 subjects with 211 nonunions. Blood samples were drawn for laboratory analysis of WBC, ESR, and CRP before surgery. The reference standard used to define infection was the fracture-related infection confirmatory criteria. Measures of diagnostic accuracy were calculated. To assess the additional diagnostic gain of each index lab test while simultaneously considering the others, logistic regression models were fit. The prevalence of infection was 19% (40 of 211 nonunion sites). The positive likelihood ratios (95% confidence interval) for WBC, ESR, and CRP were 1.07 (0.38-3.02), 1.27 (0.88-1.82) and 1.57 (0.94-2.60), respectively. Multivariable modeling adjusted for the effect of preoperative antibiotics showed that WBC (P = 0.42), ESR (P = 0.48), and CRP (P = 0.23) were not significant predictors of infection. In this consecutive sample of 211 nonunions in whom standard clinical practice would be to obtain index lab tests, our findings showed that WBC, ESR, and CRP were not significant predictors of infection. Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Sensitivity and Specificity of Serum and Synovial Fluid Markers in Diagnosis of Infection in Head-Neck Taper Corrosion of Metal-On-Polyethylene Total Hip Arthroplasty

BackgroundThe accurate diagnosis of periprosthetic joint infection (PJI) in the setting of adverse local tissue reactions in patients with metal-on-polyethylene (MoP) total hip arthroplasty (THA) secondary to head-neck taper junction corrosion is challenging as it frequently has the appearance of purulence. The aim of this study is to evaluate the utility of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and synovial fluid markers in diagnosing PJI in failed MoP THA due to head-neck taper corrosion. MethodsA total of 89 consecutive patients with MoP THA with head-neck taper corrosion in 2 groups was evaluated: (1) infection group (n = 11) and (2) noninfection group (n = 78). All patients had highly crossed polyethylene with cobalt chromium femoral heads and had preoperative synovial fluid aspiration. In addition, serum cobalt and chromium levels were analyzed. ResultsThe optimal cutoff value for synovial white blood cell was 2144 with 93% sensitivity and 84% specificity. Neutrophil count optimal cutoff value was 82% with 93% sensitivity and 82% specificity. Receiver operating characteristic analysis of ESR and CRP determined optimal cutoff at 57 mm/h and 35 mg/L with 57% sensitivity and 94% specificity and 93% sensitivity and 76% specificity, respectively. There were no significant differences in metal ion levels between the infected and noninfected groups. ConclusionThe results of this study suggest that ESR and CRP are useful in excluding PJI, whereas both synovial white blood cell count and neutrophil percentage in hip aspirate are useful markers for diagnosing infection in MoP THA patients with head-neck taper corrosion associated adverse local tissue reaction.

Result Analysis of Erythrocyte Sedimentation Rate (ESR) For Tuberculosis (TB) Patient with Anti-Tuberculosis Drug

Result Analysis of Erythrocyte Sedimentation Rate (ESR) For Tuberculosis (TB) Patient with Anti-Tuberculosis Drug

Effects of High Doses of X-Ray on Hematological Parameters and Morphology of Red Blood Cells in Human Blood

Introduction: The aim of the current study was to investigate the effects of X-ray radiation on some hematological parameters, morphology of red blood cells (RBC) and erythrocyte sedimentation rate (ESR) analysis of human blood using computed tomography (CT) scanner. Material and Methods: For the purpose of the study, 5 ml of wholeblood was drawn from vein puncture of 28 healthy people and divided into two equal parts in ethylendiamintetracetic acid (EDTA) tubes. The first 28 tubes were assigned as the controls. The second 28 tubes were divided into 4 groups of 7 cases, irradiated to (3, 6, 9, and 12) Gy, X-ray from a computed tomography CT-scan machine. Results: The results showed that no significant difference was observed for the hematological parameters and ESR analysis. However, there was a significant decrease in the radius of RBCs.In this regard, the mean RBC counts were obtained as 6.267 ± 0.528, 6.867 ± 0.476, 7.167 ± 0.535, and 6.55 ± 0.295 μm after exposure to the radiation doses of 3, 6, 9, and 12 Gy, respectively. The crenation of the cells was also observed, and the percentage of crenation were <5%, 15%, 40%, and 60% after irradiation to 3, 6, 9, and 12 Gy, respectively. Conclusion: The in vitro irradiation of human blood to different X-ray doses (i.e.,3, 6, 9, and 12 Gy), resulted in the enhancement of RBCs crenation with increasing the dose, and reduction of the cell radius compared to those in the control groups. However, the hematological parameters and ESR analysis were not statistically affected.

Evaluation of Chest Radiographic Patterns and Its Relationship with Hematological Parameters in Patients with Pulmonary Tuberculosis in Lagos Metropolis, Nigeria

Background: Pulmonary Tuberculosis (TB) is a major cause of morbidity and mortality worldwide. It is a major public health challenge in Nigeria with an estimated prevalence of 616 cases per 100,000. The aim of this study was to identify chest radiographic patterns in patients with pulmonary tuberculosis in Lagos Metropolis and investigate the relationship between these patterns and hematological parameters. Materials and Methods: A prospective cross sectional study design was adopted in this study. All the investigations were performed using standard protocols and parameters by both Radiographers and Medical Laboratory Scientists with the necessary equipment’s such as static X-ray machine and SWELAB Haematology analyzer (Manufactured by Sysmex Corporation Kobe, Japan). The anthropometric variables (height, weight, and Body Mass Index BMI) for all the subjects were measured and documented. All confirmed TB subjects at the time of diagnosis were subjected to chest X-ray investigation, ESR (Erythrocyte Sedimentation Rate) measurement and full blood count analysis. The reports were recorded with the subject’s biodata and anthropometric variables. Results: Males were 131 (72.4%) with a mean age of 34.77 ± 9.23 years and 50 (27.6%) were females with a mean age of 32.16 ± 8.72 years. All the patients had increased Erythrocyte Sedimentation Rate (ESR) and 98% had anaemia while about 71% of the patients presented with increased lymphocytes count. The radiographic patterns identified in this study were consolidation (57.5%) as highest and the least was pleural effusion (1.1%). The result of correlation analysis of ESR, WBC and PCV (Packed Cell Volume) showed no statistically significant correlation between ESR (r=-0.649, p=0.16), PCV (r=0.549, p=0.26), WBC (White Blood Cell) (r=-0.325, p=0.53) and the various chest radiographic patterns. Conclusion: This study revealed that the most predominant chest radiographic pattern is consolidation with pleural effusion as the least. There was no statistically significant relationship between the various chest radiographic patterns and hematological parameters in patients with pulmonary tuberculosis in Lagos Metropolis.