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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
White cell count: This may be increased or decreased: Neutrophilia: may accompany septic arthritisEosinophilia: may occur in polyarteritis nodosa (PAN)Neutropenia: a feature of Felty's syndrome and drug sensitivityLeucopenia: a manifestation of lupus and treatment with cytotoxic drugs (e.g. azathioprine)
Translating the Medical Record
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Blood studies assess disorders of cell production (hematopoiesis), synthesis, and function. Examination of the blood and bone marrow are the primary means of determining blood disorders. Venipuncture is used to procure larger samples of blood for testing. Bone marrow specimens are obtained through needle biopsy or aspiration. A hemogram includes platelet count, white blood cell count (WBC), red blood cell count (RBC), hematocrit (Hct), and indices. A complete blood count (CBC) includes a hemogram plus differential count.
The Lung and the Pleura
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Cytological examination of the sputum is another noninvasive diagnostic procedure that carries an accuracy of 60 to 70%. However, the results will depend on optimal conditions of collecting the sputum, i.e., it should be processed while fresh, without delay, in multiple specimens, and by an expert cytopathologist. The use of nebulizers can help in collecting the specimens. Centrally located lesions have a better yield on a positive cytology than a peripherally located lesion. Metastatic carcinomas to the lung have the lowest yield. While a positive cytology is highly significant, a negative cytology does not rule out the presence of a tumor. A positive sputum cytology in a patient with a negative chest X-ray requires further investigation of the oral cavity, oropharynx, and larynx as well as the tracheobronchial tree. Occasionally, a patient may present with pleural effusion, and cytological examination of this fluid can be helpful over 50% of the time. The presence of over 100,000 RBCs per cm2 is highly suggestive of a malignant tumor. On the other hand, the presence of high white cell count may indicate an inflammatory process (if the polymorph count is elevated) or a chronic process (if the lymphocyte count is elevated) such as tumor or tuberculosis.
The inhibitory effect of boric acid on hypoxia-regulated tumour-associated carbonic anhydrase IX
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2022
Zainab Saad Yusuf, Tugba Kevser Uysal, Ender Simsek, Alessio Nocentini, Sameh Mohamed Osman, Claudiu T. Supuran, Özen Özensoy Güler
The cell lines used in the experiments, HT29 (ATCC HB-38) and A375 (ATCC CRL 1619), were grown in Dulbecco’s modified Eagle medium (DMEM) supplemented with 10% foetal bovine serum (FBS) and treated with 1% penicillin-streptomycin. Cells were incubated at 37 °C and 5% CO2 in 25cm3 flasks. On reaching 80–90% confluence, cell harvesting was performed by washing cells in phosphate-buffered saline (PBS) and then detached from the flask surface using trypsin-EDTA. Cell count was determined using a hematocytometer. Two separate cultures each for both HT29 and A375 were grown, one under normoxic conditions and the second one under hypoxic conditions. The normoxic cultures for HT29 and A375 were grown and incubated at normoxic conditions (37 °C and 5% CO2). The hypoxic cultures (2% O2) of HT29 and A375 were cultured by using a hypoxic chamber with a gas mixture of 10% CO2, 88% N2, and 2% O2 (Stemcell Technologies, Cambridge, UK) according to the manufacturer’s instruction. The hypoxic chamber was placed in a 37 °C incubator for 4 h. Hypoxia conditions were confirmed by detecting HIF-1α protein level by using an ELISA kit (Shangai Koon, Shanghai, China).
Chronic immune thrombocytopenia in a child with X-linked agammaglobulinemia-an uncommon phenotype
Published in Platelets, 2022
Jing Yin, Jijun Ma, Xiaoxue Liu, Jingyue Xia, Qi Ai, Chongwei Li
The patient showed no hemorrhagic symptoms until he was 9 months old when he presented with cutaneous bleeding. There was no family history of congenital thrombocytopenia. He looked well with no other manifestations or prodromal symptoms. A full blood count revealed a low platelet count of 19 × 109/L, and normal hemoglobin and white blood cell count. There were no signs of red cell fragments in the peripheral smear, and all etiological examinations, such as herpes viruses, common respiratory viruses, enterovirus, and human parvovirus B19 were all negative. Although his platelet counts initially improved with high dose IVIG therapy (2 g/kg), he eventually became refractory to IVIG. Further, bone marrow aspiration revealed trilineage hematopoiesis and megakaryocyte hyperplasia, which was consistent with ITP. No antiplatelet antibodies against glycoprotein (GP)IIb/IIIa, GPIb/Ix and GPIa/IIa were detected by enzyme-linked immunosorbent assay. Oral prednisone (15 mg/day; 1.5 mg/kg/day) was administered when he was 10 months old, and the platelet count was normalized thereafter. Whole-exome sequencing was performed at another institution for suspected X-linked congenital thrombocytopenia (XLT) and identified the same BTK mutation with no mutations for Wiskott-Aldrich syndrome. With the rapid tapering of prednisone to 1.25 mg/day within one month, his platelet count declined, and a more frequent IVIG (2 g/kg/dose) was necessary.
Management of Wolff-Parkinson-White syndrome in a patient with peripartum cardiomyopathy
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Snigdha Bendaram, Sherif Elkattawy, Muhammad Atif Masood Noori, Hardik Fichadiya, Sarah Ayad, Parminder Kaur, Raja Pullatt, Fayez Shamoon
In ED, the patient was found to have a BP of 76/50. EKG (EKG a) showed Narrow complex tachycardia with a nonspecific intraventricular block and a heart rate of 190 beats per minutelikely mechanism being orthodromic AVRT given presence of delta wave in prior resting EKG. Also, a QTc of 533 milliseconds was noted. Serum magnesium was 1.6 mg/dl, which was repleted. She was treated with two doses of 100 mg intravenous procainamide, which reverted the cardiac rhythm to sinus rhythm and raised the patients blood pressure to 110/70 mmHg. A white blood cell count of 12,4004/mm3 (Normal range 4,000–10,000) was noted. Brain natriuretic peptide levels were 916 pg/ml (Normal <100). Chest X-ray showed findings suggestive of a small left pleural effusion; CT angiography was negative for Pulmonary embolism but did show findings concerning left lower lobe bronchopneumonia with trace pericardial and bilateral pleural effusions. The patient was given ceftriaxone and doxycycline, was continued on procainamide infusion and admitted to the Intensive care unit for further management.