scholarly journals P.040 Redefining true leukocytosis in the traumatic lumbar puncture

2016 ◽  
Vol 43 (S2) ◽  
pp. S30-S31
Author(s):  
SA Rizvi ◽  
F Moien-Afshari ◽  
M Ghafarian
Keyword(s):  
Lumbar Puncture ◽  
Blood Count ◽  
Complete Blood Count ◽  
Delayed Diagnosis ◽  
Clinical Suspicion ◽  
Pediatric Age ◽  
Correction Formula ◽  
Adult Age ◽  
High Clinical Suspicion ◽  
The Relationship

Background: Clinicians rely on a correction formula (Predicted CSFWBC=CSFRBC×BloodWBC/ BloodRBC) to determine if a true CSF leukocytosis exists. This formula may overestimate true CSF leukocytosis leading to delayed diagnosis and treatment of meningitis. Methods: A retrospective review of CSF data of 105 patients registered at 3 hospitals (Saskatoon, Canada) between 2011-2013 who met the following criteria: 1) CSF samples from lumbar puncture (LP) contained≥1000 RBC/mm3; 2) a complete blood count (CBC) performed within 24 hours of LP; and 3) CSF not obtained due to high clinical suspicion of meningitis and was negative for microbial staining and culture. Regression analysis was performed to determine the relationship between actual and predicted CSF WBC values. Results: Mean adult age was 48.9 years; CSF profile (mean WBC 146.3×106/L; RBC 17374×106/L; glucose 4.1 mmol/L; protein 1.4 g/L); mean peripheral WBC 8.2×109/L; RBC 3.9×109/L. Mean pediatric age was 1.4 years; CSF profile (mean WBC 171.8; RBC 41763; glucose 2.7; protein 1.7); mean peripheral WBC 12; RBC 7.2. The observed LP CSF WBC value was 47% of predicted (r2=0.54 pediatric cohort; r2=0.91 adult cohort). Conclusions: True CSF leukocytosis in both pediatric and adult patients could be missed in a traumatic CSF sample if correction is based on current formulas. We propose a modifcation: ObservedCSFWBC=0.5×[CSFRBC×BloodWBC/BloodRBC].

scholarly journals Redefining true leukocytosis in the traumatic lumbar puncture

2015 ◽  
Vol 42 (S1) ◽  
pp. S30-S30
Author(s):  
SA Rizvi ◽  
F Moein-Afshari
Keyword(s):  
Lumbar Puncture ◽  
Blood Cells ◽  
White Blood Cells ◽  
Pediatric Age ◽  
Correction Formula ◽  
Adult Age ◽  
Delayed Treatment ◽  
L Protein ◽  
The Relationship ◽  
Compare And Contrast

Objective: To compare and contrast the observed versus predicted number of white blood cells (WBCs) in a traumatic cerebrospinal fluid (CSF) sample in children and adults. Background: Clinicians rely on a correction formula (Predicted_CSF_WBC=CSF_RBC×Blood_WBC/Blood_RBC) to determine if a true CSF leukocytosis exists. This formula may overestimate true CSF leukocytosis and lead to delayed treatment of meningitis. Methods: A retrospective review of CSF data of 105 patients who met the following criteria: 1) CSF from lumbar puncture (LP) contained≥1000 RBC/mm^3 and 2) CBC performed≤24 hours of LP; 3) negative CSF cultures. Regression analysis was performed to determine the relationship between actual and predicted CSF WBC values. Results: Regression modeling indicated a discrepancy in the predicted versus actual WBC values. Mean adult age was 48.9 years; CSF profile (mean WBC 146.3×10^6/L; RBC 17374×10^6/L; glucose 4.1 mmol/L; protein 1.4 g/L); mean peripheral WBC was 8.2×10^9/L; RBC 3.9×10^9/L. Mean pediatric age was 1.4 years; CSF profile (mean WBC 171.8x10^6/L; RBC 41763x10^6/L; glucose 2.7 mmol/L; protein 1.7 g/L); mean peripheral WBC was 12×10^9/L; RBC 7.2×10^9/L. Observed LP CSF WBC value was 47% of predicted (r^2=0.54 pediatric cohort; r^2=0.91 adults). Conclusion: True CSF leukocytosis could be missed in a traumatic CSF sample based on a currently applied correction formula. We propose the following modifcation: Observed_CSF_WBC=0.5x[CSF_RBC×Blood_WBC/Blood_RBC].

scholarly journals The Effect of Complete Blood Count Timing on Lumbar Puncture Rates in Asymptomatic Infants Born to Mothers with Chorioamnionitis

Cureus ◽  
2018 ◽  
Author(s):  
Sadaf H Kazmi ◽  
Sean M Bailey ◽  
Pradeep V Mally ◽  
Sourabh Verma ◽  
William Borkowsky ◽  
...  
Keyword(s):  
Lumbar Puncture ◽  
Blood Count ◽  
Complete Blood Count

Concomitant Rash and Blood Dyscrasias in Geriatric Psychiatry Patients Treated with Carbamazepine

1998 ◽  
Vol 32 (9) ◽  
pp. 884-887 ◽  
Author(s):  
Marshall Cates ◽  
Richard Powers
Keyword(s):  
Blood Count ◽  
Geriatric Patients ◽  
Complete Blood Count ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Geriatric Psychiatry ◽  
Drug Induced ◽  
Carbamazepine Therapy ◽  
A Prospective Study ◽  
The Relationship

BACKGROUND: Rashes and blood dyscrasias are disconcerting adverse effects associated with carbamazepine therapy. Rashes are quite common, as are mild blood dyscrasias, such as mild leukopenias. Fortunately, severe rashes and blood dyscrasias are rare. There are few reports on the relationship between carbamazepine-induced rashes and blood dyscrasias, including a prospective study in which rash appeared concomitantly with leukopenia and/or thrombocytopenia in 10 patients, two case reports in which simultaneous rash and agranulocytosis occurred, and two case reports in which rashes served as harbingers of fatal aplastic anemia. CASE REPORTS: We report two cases of concomitant rashes and blood dyscrasias in geriatric psychiatry patients receiving carbamazepine therapy for bipolar disorder. One patient was found to have a severe leukopenia within several days after rash onset. The other patient was discovered to have a severe leukopenia and thrombocytopenia within about a month after rash onset. DISCUSSION: Current hematologic monitoring guidelines for carbamazepine rely heavily on the recognition of signs and symptoms of blood dyscrasias by clinicians and patients. We believe that our cases support the suggestion that patients who develop rashes receive more vigilant monitoring of the complete blood count, should carbamazepine therapy be continued. Given the currently available case reports and the fact that the incidence of drug-induced blood dyscrasias increases with advanced age, this recommendation may be particularly relevant for geriatric patients. CONCLUSIONS: Further study is required to establish whether carbamazepine-induced concomitant rashes and blood dyscrasias are valid associations insofar as monitoring is concerned.

The Relationship Between the Gensini Score and Complete Blood Count Parameters in Coronary Artery Disease

2012 ◽  
Vol 15 (2) ◽  
pp. 51-54 ◽  
Author(s):  
Muhammet Raşit Sayın ◽  
Mehmet Ali Çetiner ◽  
Turgut Karabağ ◽  
Sait Meut Doğan ◽  
Mustafa Aydın ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Blood Count ◽  
Complete Blood Count ◽  
Gensini Score ◽  
Artery Disease ◽  
The Relationship

The Association between Bone Mineral Density and Complete Blood Count in Postmenopausal Women: A Cross-Sectional Study

2021 ◽  
Vol 104 (3) ◽  
pp. 432-437
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Blood Count ◽  
Complete Blood Count ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Study Results ◽  
The Relationship

Objective: To demonstrate the relationship between anemia and complete blood count (CBC) parameters with bone mineral density (BMD) in postmenopausal women. Materials and Methods: A cross-sectional chart-review study was conducted between November 2017 and June 2019. Three hundred twenty-four postmenopausal women aged 50 years or older who had BMD and CBC results were included in the present study. Results: The prevalence of osteopenia and osteoporosis diagnosed by T-score were 53.1% and 32.7%, respectively. Simple and multiple linear regression analyses showed that no association between CBC parameter with BMD except basophil count, which was negatively associated with BMD (p=0.011). There was no correlation between anemia and BMD status (p=0.168). Conclusion: CBC parameters such as hemoglobin or white blood cell count were not statistically correlated with BMD. This is the first study demonstrating that basophil count may be an associated factor for deceased BMD. Keywords: Postmenopausal women, Bone mineral density, Complete blood count, Basophil

The Relationship Between Severity of Hypothyroidism and Red Blood Cells Indices

2019 ◽  
Author(s):  
Fakhredin Saba ◽  
Fatemeh Sayyadipoor
Keyword(s):  
Thyroid Hormones ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Thyroid Dysfunction ◽  
Blood Count ◽  
Complete Blood Count ◽  
Oxygen Metabolism ◽  
First Time ◽  
The Relationship ◽  
Cell Counter

Background and Aims: Thyroid hormones have an important role in metabolism and regulation of the red blood cells (RBCs). Thyroid dysfunction induces various effects on blood cells such as anemia through reducing the oxygen metabolism. For the first time, we aimed to determine the effects of severity activation of hypothyroidism on RBCs indices in patients with hypothyroidism. Materials and Methods: This study was performed on 79 patients with hypothyroidism. Initially patients' TSH level was determined by immunoassays method, and then according to TSH ranges (0.3-5.5 µIU/mL), patients were divided into two moderate hypothyroidism (45 individuals) (TSH 6-10 µIU/mL) and marked hypothyroidism (34 individual) (TSH>10 µIU/mL) groups. Then, complete blood count was measured by cell counter. Results and conclusions: Data analysis revealed a statistically difference between the two groups of patient including moderate and marked hypothyroidism in RBCs count (4.46 versus 4.04 mil/L), hemoglobin (12.8 versus 12.3 g/dl) and hematocrit (39.8 versus 38.0 %) respectively. It seems that severly reduced hormones of thyroid may result in markedly decrease in RBCs count, hemoglobin and hematocrit. These finding are consistent with the fact that reduced thyroid hormones may cause anemia frequently through effect on cytokines involving erythropoiesis such as erythropoietin

scholarly journals Relationship of Meteorological and Air Pollution Parameters with Pneumonia in Elderly Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Suleyman Serdar Tasci ◽  
Cemil Kavalci ◽  
Afsin Emre Kayipmaz
Keyword(s):  
Blood Count ◽  
Meteorological Parameters ◽  
Complete Blood Count ◽  
Airborne Particles ◽  
Meteorological Variables ◽  
Nitrite Oxide ◽  
Number Of Patients ◽  
Pm 10 ◽  
Relationship Of ◽  
The Relationship

Background and Purpose. In this study, we aimed to evaluate the relationship between pneumonia and meteorological parameters (temperature, humidity, precipitation, airborne particles, sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), nitrite oxide (NO), and nitric oxide (NOX)) in patients with the diagnosis of pneumonia in the emergency department. Methods. Our study was performed retrospectively with patients over 65 years of age who were diagnosed with pneumonia. The meteorological variables in the days of diagnosing pneumonia were compared with the meteorological variables in the days without diagnosis of pneumonia. The sociodemographic characteristics, complete blood count of the patients, and meteorological parameters (temperature, humidity, precipitation, airborne particles, SO2, CO, NO2, NO, and NOX) were investigated. Results. When the temperature was high and low, the number of days consulted due to pneumonia was related to low air temperature (p<0.05). During the periods when PM 10, NO, NO2, NOX, and CO levels were high, the number of days referred for pneumonia was increased (p<0.05). Conclusion. As a result, climatic (temperature, humidity, pressure levels, rain, etc.) and environmental factors (airborne particles, CO, NO, and NOX) were found to be effective in the number of patients admitted to the hospital due to pneumonia.

Accuracy of MRI in Diagnosing Appendicitis during Pregnancy

2018 ◽  
Vol 84 (8) ◽  
pp. 1326-1328 ◽  
Author(s):  
Fabiola Aguilera ◽  
Brian F. Gilchrist ◽  
Daniel T. Farkas
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Delayed Diagnosis ◽  
Clinical Suspicion ◽  
Diagnosis And Treatment ◽  
Pathology Report ◽  
Mri Findings ◽  
Suspected Appendicitis ◽  
High Clinical Suspicion ◽  
Group 3

Appendectomy for presumed appendicitis is the most common surgical emergency during pregnancy. Delayed diagnosis and treatment of appendicitis carries risk for the fetus and mother. We sought to evaluate the accuracy of MRI in pregnant patients with suspected appendicitis. All pregnant patients with suspected appendicitis between January 2014 and April 2016 were included. MRI reports were categorized into positive, negative, and inconclusive groups. Diagnosis of appendicitis was based on pathology report. Fifty-two patients were included in the study. The MRI was positive in two, negative in 29, and inconclusive in 21 patients. Twelve patients had surgery, 11 of which had positive appendicitis on pathology. Both positive MRI patients had appendicitis. In the negative MRI group, 3 of 29 (10%) had appendicitis. In the inconclusive MRI group, 6 of 21 (29%) had appendicitis. A positive MRI result was very specific with a 100 per cent positive predictive value; however, the sensitivity was as low as 18 per cent (diagnosed only 2 of 11 cases). Although a positive MRI finding was reliable in making a decision to operate, a negative or inconclusive MRI was not. In patients with a high clinical suspicion of appendicitis, surgery should still be considered even without definitive positive MRI findings.

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