1,720,999 research outputs found
Opportunities and Drawbacks of Digitalized Morphologic Analysis of Body Fluids
No full textBody fluid analysis has become a critical component of diagnostic and clinical decision-making for a wide spectrum of human pathologies. An automated microscope, a high-quality digital camera, and a software designed to identify and automatically preclassify cells and other features in stained smears comprise the most recent generation of digital morphologic analyzers. The time necessary for expert operator reclassification is another aspect that must be considered at this stage of development, because identifying and sorting distinct elements in body fluids still necessitates the involvement of an expert morphologist
Harmonization of laboratory hematology: a long and winding journey
No full textHarmonization of laboratory hematology: a long and winding journe
Platelet Transfusion Thresholds: How Low Can We Go in Respect to Platelet Counting?
No full textPlatelet transfusion is conventionally used to prevent or treat bleeding in patients with low platelet counts or impaired platelet function. The identification of accurate thresholds of platelet count for guiding platelet transfusion practices is a crucial aspect in health care to prevent adverse events, side effects, unwarranted costs for the health care service, and deprivation of supplies. This article is therefore aimed at providing a narrative overview on current guidelines and recommendations for platelet transfusion across many clinical settings, including platelet function disorders, and critically analyzing the available platelet transfusion thresholds according to the current analytical performance of platelet counting with automated hematological analyzers. Overall, universal agreement on the definition of platelet transfusion thresholds has not been reached. The degree of accuracy and imprecision of many fully automated hematological analyzers appears also unsatisfactory, especially at the lower thrombocytopenic range, and this may thus jeopardize the managed care of patients who are candidates for platelet transfusions. Potential solutions to overcome the current shortcomings of automated platelet counting are also discussed, encompassing the use of alternative tests for guiding platelet transfusion (e.g., thrombin generation assays or thromboelastography) along with innovative approaches for platelet enumeration (e.g., fluorescent labeling and flow cytometry)
Harmonization of interpretative comments in laboratory hematology reporting: the recommendations of Working Group on Diagnostic Hematology of the Italian Society of Clinical Chemistry and Clinical Molecular Biology (WGDH-SIBioC)
No full textThe goal of harmonizing laboratory testing is contributing to improving the quality of patient care and ultimately ameliorating patient outcome. The complete blood and leukocyte differential counts are among the most frequently requested clinical laboratory tests. The morphological assessment of peripheral blood cells (PB) through microscopic examination of properly stained blood smears is still considered a hallmark of laboratory hematology. Nevertheless, a variable inter-observer experience and the different terminology used for characterizing cellular abnormalities both contribute to the current lack of harmonization in blood smear revision. In 2014, the Working Group on Diagnostic Hematology of the Italian Society of Clinical Chemistry and Clinical Molecular Biology (WGDH-SIBioC) conducted a national survey, collecting responses from 78 different Italian laboratories. The results of this survey highlighted a lack of harmonization of interpretative comments in hematology, which prompted the WGDH-SIBioC to develop a project on "Harmonization of interpretative comments in the laboratory hematology report", aimed at identifying appropriate comments and proposing a standardized reporting system. The comments were then revised and updated according to the 2016 revision of the World Health Organization classification of hematologic malignancies. In summary, the purpose of revaluating comments was aimed at: (a) reducing their overall number, (b) standardizing the language
Cell population data and reflex testing rules of cell analysis in pleural and ascitic fluids using body fluid mode on sysmex XN-9000
No full textBACKGROUND: Although optical microscopy (OM) remains the reference technique for analysis of ascitic (AF) and pleural (PF) fluids, novel hematological analyzers are equipped with modules for body fluids (BFs) analysis. This study was aimed to analyze the performance of XN-BF module in Sysmex XN-9000, and to develop validation rules for automated cell counts in BFs.METHODS: The evaluation of XN-BF module included assessment of carryover, Limit of Blank (LoB), Limit of Detection (LoD), Limit of Quantitation (LoQ), linearity, data comparison with OM, and development of rules for assisting the validation of automated analysis of BFs and activating reflex testing.RESULTS: The carryover was negligible. The LoB, LoD, LoQ and linearity were always excellent. The comparison with OM was characterized by Pearson's correlations ranging from r=0.50 to r=0.99 (p<0.001), modest bias and high diagnostic concordance (Area Under the Curve between 0.85-0.99). The use of instrument-specific cut-offs further increased diagnostic concordance. The implementation of reflex testing rules based on XN-BF data increased sensitivity and specificity of BFs classification to 0.98 and 0.95.CONCLUSIONS: Our results suggest that the XN-BF module on Sysmex-9000 may be a suitable alternative to OM for screening BF samples, especially when specific validation rules are used
Validation rules for blood smear revision after automated hematological testing using Mindray CAL-8000
No full textThis article was aimed to test the use of validation rules for blood smear review after automated hematological testing using Mindray CAL-8000 (two hematological analyzers and one autoslider)
Biological variation estimates of complete blood count parameters in healthy subjects
No full textBackground: the complete blood count (CBC) is the test more frequently requested in clinical practice. Therefore, estimating the biological variation (BV) of CBC parameters is essential for assessing the analytical performance of hematological analyzers and for enabling accurate data interpretation and appropriate clinical management. This study was aimed to define BV estimates and reference change value (RCV) of CBC parameters. Methods: the study population consisted of 21 healthy volunteers, who had BV of CBC parameters assessed with Sysmex XN. The study protocol, the analytical measurements and the statistical analysis were carried out according to current recommendations of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM). Results: Within-subject BV ranged between 0,3% for mean cell hemoglobin (MCH) and 19,7% for immature granulocytes (IG), whilst between-subjects BVs ranged between 0,9% for mean corpuscolar haemoglobin concentration (MCHC) and 66,6% for microcytic red blood cells (Micro-R). The RCV ranged between 2,3% for MCH and 73,5% for IG. Conclusion: This study has allowed the estimation of BV of many CBC parameters, some of which have not been currently explored, thus leading the way to use RCV calculated according to time of monitoring and/or differentiated by sex
A specific abnormal scattergram of peripheral blood leukocytes suggestive for the presence of proerythroblast
No full textA specific abnormal scattergram of peripheral blood leukocytes suggestive for the presence of proerythroblast
The diagnosis of malaria: the role of the haematology analyzers as first level screening
No full textMalaria is one of the three most common infectious diseases worldwide, and is caused mainly by four species of Plasmodium: P. falciparum, P. vivax, P. malariae and P. ovale. The disease is endemic in developing countries but it is also gradually involving Western Countries like Italy. Albeit in 1970 the World Health Organization has included Italy among the malaria-free countries, malaria has become the most frequently imported tropical disease. Microscopic examination of the peripheral blood smear is the gold standard for diagnosing malaria. Although this test is quick, cheap and readily applicable, it has also some drawbacks such as low sensitivity and the need of qualified personnel. Therefore, an effective screening test for detecting malaria in cases with low clinical suspicion or characterized by non-specific symptoms is increasingly necessary, especially in Countries where the disease is not endemic. A new generation of hematological analyzers, whose performance may be potentially useful for the screening of subjects with suspected malaria infection has made available. Many fully-automated hematological analyzers, using different techniques (optical-cytochemical, optical fluorescence, multiangle polarized dispersion and volume-conductance-scatter), can now identify the presence of the malarial parasites in peripheral blood, producing specific cell distributions. The blood count can hence be regarded as a new diagnostic opportunity in malaria infection, since it is one of the basic investigations performed in febrile patients, and is also a simple and fast test, that can be performed in virtually all clinical laboratories
Automated cerebrospinal fluid cell counts using the new body fluid mode of Sysmex UF-1000i
No full textBackground: We evaluated the new body fluid module on Sysmex UF1000i (UF1000i-BF) for analysis of white blood cell (WBC) and red blood cell (RBC) in cerebrospinal fluid (CSF). Methods: WBC and RBC counting were compared between UF1000i-BF and Fuchs-Rosenthal counting chamber in 67 CSF samples. This study also included the evaluation of between-day precision, limit of blank (LoB), limit of detection (LoD), functional sensitivity (limit of quantitation, LoQ), carryover and linearity. Diagnostic agreement for differentiation between normal and increased WBC counts (>= 5.0 x 10(6)/L) was also assessed. Results: The agreement between UF1000i-BF and manual WBC counts was otpiaml in all CSF samples (r = 0.99; y = 1.05x + 0.09). A modest overestimation was noticed in samples with WBC = 18 x 10(6)/L (r = 0.98; y = 1.01x + 8.90). Between-day precision was good, with coefficient of variations (CVs) lower than 7.2% for both WBC and RBC. The LoBs were 0.1 x 10(6) WBC/L and 1.2 x 10(6) RBC/L, the LoDs were 0.7 x 10(6) WBC/L and 5.5 x 10(6) RBC/L, the LoQswere 2.4x10(6) WBC/L and 18.0 x 10(6) RBC/L, respectively. Linearity was excellent (r = 1.00 for bothWBC and RBC). Carryover was negligible. Excellent diagnostic agreement was obtained at 4.5 x 10(6) WBC/L cut-off (sensitivity, 100%; specificity, 97.4%). Conclusion: The UF1000i-BF provides rapid and accurate WBC and RBC counts in clinically relevant values of CSF cells. The use of UF1000i-BF may hence allow to replace routine optical counting, except for samples displaying abnormal WBC counts or abnormal scattergram distribution, for which differential cell counts may still be required. (C) 2015 Wiley Periodicals, Inc
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