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Data and Picture Interpretation Stations: Cases 1–45
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Patients should initially be managed with self-education and self-care, including saline rinses and over the counter intra-nasal corticosteroids (INCS) for 6–12 weeks. If there is no demonstrated improvement primary care should offer education about technique and compliance with saline rinses and INCS; and consider oral corticosteroids (OCS). If there is still no improvement, secondary care can arrange additional work up, including nasendoscopy to look for polyps and mucopurulent discharge, a skin prick test, laboratory testing including IgE and white blood cell differential (looking for eosinophilia), and a CT scan. If the CT scan shows blocked osteomeatal complexes (OMC) +/− polyps, then a functional endoscopic sinus surgery may help improve their symptoms.
Tests and procedures
Published in Sarah Bekaert, Women's Health, 2018
White blood cell differential measures the different types of white blood cells present. There are five different types of white blood cell, each with its own function in protecting the body from infection. The differential classifies a person’s white blood cells into the following types: neutrophils (also known as polymorphs, PMNs or granulocytes), lymphocytes, monocytes, eosinophils and basophils.
Essential Thrombocythemia
Published in Wojciech Gorczyca, Atlas of Differential Diagnosis in Neoplastic Hematopathology, 2014
The currently proposed World Health Organization (WHO)/European clinical, molecular, and pathological (ECMP) criteria for the diagnosis of ET include (C1) sustained platelet count above the upper limit of normal (≥450 × 109/L); (C2) presence of large or giant platelets in blood smear; (C3) normal values of hemoglobin, hematocrit, erythrocytes, and white blood cell differential count; (C4) presence of JAK2 mutation or MPL mutation; (C5) absence of Ph chromosome or any other cytogenetic fusion gene abnormality; (P1) increase of dispersed or loosely clustered, predominantly enlarged megakaryocytes with mature cytoplasm and hyper-lobulated nuclei; and (P2) no proliferation or immaturity of erythropoiesis and granulopoiesis and no or borderline increase of reticulin (myelofibrosis grade 0). According to the proposed WHO/ECMP criteria, C1 + P1 and P2 establish the diagnosis of true ET [14,15]. Table 29.1 presents the current WHO criteria for ET. Generally, ET can be diagnosed in patients with sustained platelet ≥450 × 109/L with JAK2 V617F (or other clonal marker) who do not meet the criteria for the diagnosis of PV, CML, PMF, myelodysplastic syndrome (MDS), and other MPNs, and whose biopsy shows atypical large and mature megakaryocytes not accompanied by BM fibrosis (in the absence of clonal marker, there should be no evidence for reactive thrombocytosis). This means that to diagnose ET one has to exclude BCR–ABL1 fusion, a significant BM reticulin or collagen fibrosis and dyserythropoiesis and dysgranulopoiesis, and to prove the failure of iron replacement therapy to increase the hemoglobin level to the PV range in the presence of decreased serum ferritin.
Comparative analysis of the oral microbiome of burning mouth syndrome patients
Published in Journal of Oral Microbiology, 2022
Byeong-Min Lee, Ji Woon Park, Jung Hwan Jo, Bumjo Oh, Gehoon Chung
Clinical examinations included thorough medical history taking based on structured questionnaires and systemic interviewing and oral examination including visual inspection and palpation of the oral mucosa and teeth to identify abnormalities such as change in color and shape reflecting active inflammation. Psychological evaluation was done with Symptom Checklist-90-Revised (SCL-90-R) [31]. Laboratory examinations were done to rule out possible systemic factors that are known to be related to abnormal oral sensations including pain. Tests included complete blood counts with white blood cell differential, hematinic-related components such as iron, ferritin, vitamin B12, and folate. Blood glucose, liver function tests (total protein, albumin, total bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and cholesterol), kidney function tests (blood urea nitrogen and creatinine), and thyroid function tests [T3 (triiodothyronine), free T4 (thyroxine), and TSH (thyroid-stimulating hormone)] were done along with calcium, phosphorus, magnesium, and zinc level analysis.
Blood eosinophils as predictor of outcomes in patients hospitalized for COPD exacerbations: a prospective observational study
Published in Biomarkers, 2021
Konstantinos Kostikas, Evgenia Papathanasiou, Andriana I. Papaioannou, Konstantinos Bartziokas, Ilias C. Papanikolaou, Emmanouil Antonakis, Ioanna Makou, Georgios Hillas, Τheodoros Karampitsakos, Ourania Papaioannou, Katerina Dimakou, Vicky Apollonatou, Galateia Verykokou, Spyros Papiris, Petros Bakakos, Stelios Loukides
Blood samples were collected from each patient at the time of admission to the emergency department and prior to the initiation of any treatment for exacerbations of COPD and standard laboratory measurements (complete blood count and C-reactive protein (CRP) mg/L). C-reactive protein was measured in milligrams of CRP per litre of blood (mg/L). CRP was measured on a routine clinical chemistry analyser, Synchron LX 20, by immunoturbidimetry, with a detection limit of 5.0 mg/L and a measuring range of 5.0–488 mg/L (Beckman Coulter, Inc., Brea, CA). Serum CRP level was measured by the CRP latex agglutination test (Biosystems CRP kit, catalogue no. 31921, Barcelona, Spain) according to the manufacture’s guidelines. Serum CRP causes agglutination of the latex particles coated with antihuman CRP. Blood cell enumeration and white blood cell differential counts including Eos, were performed in an automated haematology analyser (Coulter AcT 5diff CP Cap Pierce, Leriva, Brea, CA, at the Respiratory Medicine Department of Amalia Fleming General Hospital, Athens, Greece). All samples were analysed within 1–2 hours following blood collection without storage.
Short-term biological variation of differential count in healthy subjects in a South Asian population
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2020
Arvind Kumar Gupta, Arathi Kunnumbrath, Sakshi Garg Tayal, Anoushika Mehan, Rishabh Sahay, Utpal Kumar, Reshma Jeladharan, Michael Leonard Anthony, Neha Singh, Harish Chandra, Nilotpal Chowdhury
Studies estimating the CVI and CVG are difficult to conduct and needs relatively complicated statistical methods. Therefore, these studies have been performed in just a few areas in Europe and North America [4–10]. There have been very few studies in an Asian population [11]. For the South Asian population, only one study has been performed for common hematological parameters, but none for the white blood cell differential counts (DC). Knowledge of the biological variation in such large unstudied populations is important since we do not know whether the European and North American estimates would remain equally valid in such a setting. Therefore, we decided to estimate the within and between subject coefficients of variation for the DC, comprising of the Neutrophil Count (NC), Lymphocyte Count (LC), Eosinophil Count (EC), Monocyte Count (MC) and Basophil Count (BC).