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CytoJournal 2022Fluids are one the most common specimens received in cytology laboratories. The presence of erythrocytes may obscure the cells in the smears, making the diagnosis, and...
OBJECTIVES
Fluids are one the most common specimens received in cytology laboratories. The presence of erythrocytes may obscure the cells in the smears, making the diagnosis, and identification of cells difficult. Many techniques are being used by laboratories to eliminate these erythrocytes. The present study was undertaken to improve the quality of cytology smears of hemorrhagic samples by comparing three different techniques, namely, Carnoy's fixative (CF), modified CF, and normal saline rehydration technique (NSRT) to hemolysis red blood cells (RBC) present in the smear background for better cytological assessment. The present study was a prospective study done over 1 year 6 months from November 2012 to March 2014, in the Department of Pathology in a Tertiary Care Rural Medical College.
MATERIALS AND METHODS
All hemorrhagic effusions received in the department of pathology were processed using CF, modified CF, and NSRT. The background of the smear and cytomorphological details with two different stains was analyzed. The Chi-square test was used to find out the association of different techniques in the reduction of RBC.
RESULTS
More than 60% reduction of RBCs in the smear was noted in 85.40%, 14.60%, and 15.60% by NSRT, modified CF, and CF, respectively. Staining was better and nuclear features were best preserved in NSRT.
CONCLUSION
NSRT is the best, simple, and cheaper technique to lyse RBC in the hemorrhagic fluid. It also shows better staining and well-preserved cytomorphological features of the cell.
PubMed: 35928534
DOI: 10.25259/Cytojournal_14_2021 -
Journal of the American Association For... Mar 2022Nonterminal blood sampling in laboratory mice is a very common procedure. With the goal of improving animal welfare, different sampling sites and methods have been...
Nonterminal blood sampling in laboratory mice is a very common procedure. With the goal of improving animal welfare, different sampling sites and methods have been compared but have not achieved a consensus. Moreover, most of these studies overlooked the quality of blood specimens collected. The main preanalytical concern with EDTA-treated blood specimens for hematology analyses is platelet aggregation, which is known to cause analytical errors. Our objective was to find a nonterminal blood sampling method with minimal adverse effects on mice and few or no platelet aggregates. We tested and compared 2 collection sites, 4 sampling methods, and 3 antithrombotic drugs in 80 C57BL6/j male and female mice by evaluating platelet aggregates on blood smears and platelet, WBC, and RBC counts. In addition, the blood collection process was carefully evaluated, and adverse effects were recorded. Platelet aggregation was lower in specimens collected from the jugular vein than from the facial vein, with no effect of the sampling device or the presence of an antithrombotic additive. Highly aggregated specimens were significantly associated with lower platelet counts, whereas aggregation had no effect on WBC or RBC counts. Adverse events during sampling were significantly associated with more numerous platelet aggregates. The jugular vein is thus a satisfactory sampling site in mice in terms of both animal welfare and low platelet aggregation. Using antithrombotic agents appears to be unnecessary, whereas improving sampling conditions remains a key requirement to ensure the quality of EDTA-treated blood specimens from mice.
Topics: Animals; Blood Platelets; Edetic Acid; Female; Male; Mice; Mice, Inbred C57BL; Platelet Aggregation; Platelet Count
PubMed: 35022109
DOI: 10.30802/AALAS-JAALAS-21-000093 -
International Journal of Laboratory... Jun 2022
Topics: Blood Cells; Humans; Neisseria meningitidis
PubMed: 34921504
DOI: 10.1111/ijlh.13784 -
Blood Advances Jul 2023Graduate medical education training in hematology in North America is accredited by the Accreditation Council for Graduate Medical Education (ACGME). Trainees routinely...
Graduate medical education training in hematology in North America is accredited by the Accreditation Council for Graduate Medical Education (ACGME). Trainees routinely review peripheral blood smears (PBS) in providing clinical care. Competency in PBS review at graduation is required by the ACGME. However, there are no consensus guidelines on best practices surrounding PBS review, education, or competency. We describe the generation of proposed theory and the consensus recommendations developed through a multi-institutional focus group, developed using constructivist grounded theory and a modified nominal group technique. Eight academic hematologists, spanning classical and malignant hematology, enrolled and participated in 2 one-hour focus groups. All routinely worked with fellows and half had formally instructed trainees on PBS interpretation. Focus group data were analyzed using mixed-methods techniques. Tenets of emerging theory were identified through inductive coding. Consensus recommendations (CR) were generated. Participants reviewed CR in an iterative fashion until consensus was reached. Strong consensus was reached on multiple aspects of PBS education. All agreed that trainees should learn PBS review through a systematic approach. Group discussion focused on disorders of red and white blood cells. The diagnoses of acute leukemia and thrombotic microangiopathies were most commonly discussed, with specific emphasis on disorders in which prompt recognition was required to avert significant patient morbidity. These CR offer external validity to future research and curricular development for both PBS review and other visuospatial tasks in medical education.
Topics: Humans; Clinical Competence; Education, Medical, Graduate; Accreditation; Hematology; North America
PubMed: 36930800
DOI: 10.1182/bloodadvances.2023009843 -
Poultry Science Aug 2021A description of standard and atypical heterophils, lymphocytes, and 2 types of giant cells found in the circulation of 17 wk commercial ducks (N = 24) in apparent...
A description of standard and atypical heterophils, lymphocytes, and 2 types of giant cells found in the circulation of 17 wk commercial ducks (N = 24) in apparent good health is the subject. Heterophils were sorted as either "classic" (HC) having red rod-shaped cytoplasmic granules, "typical" (HT) having weakly stained granules providing a reticular cytoplasmic appearance, or rarely as "variant" types (HV) having orange spherical granules. Atypical HT's and HC's were in 14 of 24 (58%) of the ducks. Small lymphocytes (Ls), reactive lymphocytes and plasmacytes (Lm) were routinely found. Giant cells, also present, were placed with Lm or monocytes (Mn) depending on cytology. Two counts of 200 leukocytes gave the total white count (TWBC) and 2 heterophil/lymphocyte ratios. H/L 1 = (HT + HC +HV) / Ls; and H/L 2 = (HT + HC + HV) / (Ls + Lm). The results showed that TWBC were normal (~ 23,000 /μL) but both H/L ratios were highly variable. HT were differentiated from HC on nuclear and cytoplasmic criteria. Many HT and HC exhibited signs of deterioration. Some giant cells likely represented developmental stages. Multiple nucleoli were evident in others suggesting polyploidy. The more common lymphoid giants were usually round whereas monocyte types were irregular. Mn types were actively phagocytic often consuming thrombocytes or rarely erythrocytes (RBC). Giant cells of either type were in 13 of 24 (54%) of the duck hemograms. Conidiospores were detected in the blood smears of 4 ducks and bacteria in 2 with 1 duck having both. As all ducks were in apparent good health the blood born microorganisms likely represented low grade infections. Presumably the atypical cells were a response to the presence of toxins of bacterial and fungal origin. The presence of atypical heterophils and lymphocytes complicates interpretation of H/L ratios traditionally used to establish stress. As atypical cells can be found in the context of normal TWBC or nonstress H/L values cytological observations attain additional importance. Moreover, giant cells may be useful indicators of infection even without direct microscopic observation or isolation of the offending organisms.
Topics: Animals; Blood Cell Count; Chickens; Ducks; Leukocytes; Plasma Cells
PubMed: 34225201
DOI: 10.1016/j.psj.2021.101248 -
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi =... Jun 2022The count and recognition of white blood cells in blood smear images play an important role in the diagnosis of blood diseases including leukemia. Traditional manual...
The count and recognition of white blood cells in blood smear images play an important role in the diagnosis of blood diseases including leukemia. Traditional manual test results are easily disturbed by many factors. It is necessary to develop an automatic leukocyte analysis system to provide doctors with auxiliary diagnosis, and blood leukocyte segmentation is the basis of automatic analysis. In this paper, we improved the U-Net model and proposed a segmentation algorithm of leukocyte image based on dual path and atrous spatial pyramid pooling. Firstly, the dual path network was introduced into the feature encoder to extract multi-scale leukocyte features, and the atrous spatial pyramid pooling was used to enhance the feature extraction ability of the network. Then the feature decoder composed of convolution and deconvolution was used to restore the segmented target to the original image size to realize the pixel level segmentation of blood leukocytes. Finally, qualitative and quantitative experiments were carried out on three leukocyte data sets to verify the effectiveness of the algorithm. The results showed that compared with other representative algorithms, the proposed blood leukocyte segmentation algorithm had better segmentation results, and the mIoU value could reach more than 0.97. It is hoped that the method could be conducive to the automatic auxiliary diagnosis of blood diseases in the future.
Topics: Algorithms; Leukocytes
PubMed: 35788516
DOI: 10.7507/1001-5515.202107043 -
Romanian Journal of Internal Medicine =... Sep 2019Several diagnoses have been associated with leukemoid reaction (LR). In patients with LR the diagnostic and prognostic value of detailed manual blood smear counts (such... (Review)
Review
INTRODUCTION
Several diagnoses have been associated with leukemoid reaction (LR). In patients with LR the diagnostic and prognostic value of detailed manual blood smear counts (such as the percentage of band cells or grading of neutrophil toxic changes) has not been studied previously.
METHODS
We prospectively recorded all hospitalized adult (> 18 years old) patients with LR (≥ 30000/ul) of neutrophilic predominance, excluding patients with pre-existing leukocytosis due to hematological malignancies. We examined the diagnoses and prognosis (in-hospital mortality and post-discharge mortality up to a year after the end of the study) of these patients as well as the value of manual peripheral smear review.
RESULTS
We recorded a total of 93 patients with LR from January 2017 to December 2017. Infection was the most common diagnosis (70%), followed by malignancy (7.5%) and bleeding (6.5%). In-hospital mortality (45%) and post-discharge mortality (35% of those discharged) were very high. Among blood smear findings, only neutrophil vacuolation was significantly more common in patients with infections (34%), although it was also observed in many patients without any infection (13%). Blood smear findings were not associated with prognosis.
CONCLUSION
Detailed manual smear review is a labor-intensive procedure and it has limited diagnostic and prognostic value in unselected hospitalized patients with neutrophilic LR.
Topics: Adult; Aged; Aged, 80 and over; Blood Cell Count; C-Reactive Protein; Female; Hemorrhage; Hospital Mortality; Hospitalization; Humans; Infections; Leukemoid Reaction; Male; Middle Aged; Neoplasms; Neutrophils; Prognosis; Prospective Studies
PubMed: 30862764
DOI: 10.2478/rjim-2019-0006 -
Cytometry. Part a : the Journal of the... Apr 2023Deep learning has been used to classify the while blood cells in peripheral blood smears. However, the classification of developing neutrophils is rarely studied....
Deep learning has been used to classify the while blood cells in peripheral blood smears. However, the classification of developing neutrophils is rarely studied. Moreover, it is still unknown whether deep learning can work well on the data coming from different sources. In this study, we therefore investigate the classification performance of deep learning for immature and mature neutrophils. In particular, we used three open-access datasets obtained from different imaging systems: CellaVision DM 96, CellaVision DM 100, and iCELL ME-150. A total of 26,050 images identified by one laboratory technologist were randomly split into training, validation, and testing datasets. A total of 10 convolutional neural networks were trained to classify six blood cell types: myeloblast, promyelocyte, myelocyte, metamyelocyte, banded neutrophil, and segmented neutrophil. The experimental results showed that compared to any single model, the average ensemble model could achieve a better classification performance and provide a testing accuracy of 90.1%. The sensitivity and specificity of the average ensemble model for the six blood cell types were above 83.5% and 96.9%, respectively. Our results suggest that deep learning is a promising tool for the classification of developing neutrophils, but further improvement is required.
Topics: Neutrophils; Deep Learning; Neural Networks, Computer
PubMed: 36268593
DOI: 10.1002/cyto.a.24698 -
Turkish Journal of Haematology :... Nov 2020
Topics: COVID-19; Hematology; Humans; Pandemics; Patients; SARS-CoV-2
PubMed: 32586086
DOI: 10.4274/tjh.galenos.2020.2020.0262 -
Indian Journal of Dental Research :... 2021Oral submucous fibrosis (OSMF) is a chronic progressive scarring oral disease caused due to areca quid chewing. The constituents of areca nut can enter into the...
BACKGROUND
Oral submucous fibrosis (OSMF) is a chronic progressive scarring oral disease caused due to areca quid chewing. The constituents of areca nut can enter into the circulation by swallowing the liquid mixture of areca quid which evokes oxidative stress on RBC membrane integrity.
AIMS
To study the morphometric characteristics of erythrocytes under light microscopy and to assess the role of areca quid constituents on the morphology of circulating erythrocytes.
MATERIALS AND METHODS
Peripheral blood smears prepared from blood samples of 50 patients selected according to Lai's classification. Group I: Normal individuals (10 cases); Group II: Mouth opening > 35 mm (10 cases); Group III: Mouth opening 30-35 mm (10 cases); Group IV: Mouth opening 20-30 mm (10 cases) and Group V: Mouth opening < 20 mm (10 cases). The slides were stained with Leishman's stain and assessed by light microscopy. A total of 100 randomly selected RBCs from 5 different fields in each smear were selected and the RBC circumference was measured and tabulated.
STATISTICAL ANALYSIS AND RESULTS
Data was analyzed using GraphPad Prism 5.03 software. Tukey's multiple comparison test showed statistically significant difference (p < 0.05) between groups I and IV; I and V; II and IV; II and V; III and IV; III and V.
CONCLUSION
These results suggest the possibility of cytotoxic effect of areca quid constituents on circulating erythrocytes in advanced cases of OSMF, which might result in microcytic anaemia.
Topics: Areca; Erythrocytes; Humans; Mouth Diseases; Oral Submucous Fibrosis
PubMed: 34269232
DOI: 10.4103/ijdr.IJDR_718_18