Blood Cell Count and the Presence or Absence of Infection in Venous Ulcers Treated With Platelet-Rich Plasma

Introduction. In general, chronic wounds are colonized by bacteria; however, when microorganisms start to multiply at higher levels, wounds can become infected, causing prolongation of the inflammatory phase and retardation of collagen synthesis and epithelialization. Objective. The objective of this study was to evaluate the presence of infection in venous ulcers after 12 weeks of treatment with autologous platelet-rich plasma (PRP) and determine global white blood cell counts. Materials and Methods. This case series study involved a sequential sample of 17 patients with venous ulcers treated with PRP for 12 weeks. Descriptive and inferential statistical analysis was performed using the McNemar test and χ² test. Results. At baseline, 10 patients (58.8%) had wound infection. During the sixth week of treatment with PRP, only 3 patients (17.6%) continued to exhibit wound infection. After 12 weeks of PRP treatment, only 1 patient (5.9%) continued to exhibit wound infection. McNemar and χ² tests used to assess the presence of infection in the intervention group produced a P value of .0039 for a comparison of baseline and week 6 and a P value of .0078 for a comparison of baseline and week 12. These results demonstrated significant differences from baseline at both 6 weeks and 12 weeks of treatment, with greater significance at 12 weeks. There was no relationship between global white blood cell count and the presence of infection. Conclusion. After intervention with PRP, 94% of patients experienced improvement concerning the infection of ulcers.

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788. Evaluation of a Multiplex PCR Panel and Confirmatory Cytotoxin Testing on Clostridioides difficile at a Pediatric Hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.978 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S438-S438

Author(s):

Michael J Lauth ◽

Greg Cook ◽

Margarita Silio

Keyword(s):

Blood Cell ◽

Cell Count ◽

Multiplex Pcr ◽

White Blood Cell Count ◽

White Blood Cell ◽

Antibiotic Use ◽

P Value ◽

Pediatric Hospital ◽

Blood Cell Count ◽

Clostridioides Difficile

Abstract Background With the introduction of gastrointestinal multiplex PCR (mPCR) tests, clinicians have received an increased number of positive tests for Clostridioides difficile. Patients who test positive via mPCR may not have a positive toxin assay indicative of true infection and may not need antibiotics. The goal of this study was to assess the symptoms of patients who test positive for C. difficile and determine the impact on antibiotic use at a pediatric hospital. Methods A single-center, retrospective review was completed from May 2018 to March 2020. Initial C. difficile screening tests were performed via an mPCR test or a mono-PCR test. Patients > 1 year of age had a reflex cytotoxin assay performed. The primary outcome was the difference in symptoms between cytotoxin positive and negative patients. Secondary outcomes included co-pathogen detection on mPCR and C. difficile antibiotic days of therapy. Results Four hundred and sixty-one patients were included in our chart review. 49% of patients had a positive mPCR for a GI pathogen (n=229), and 18% (n=82) were positive for C. difficile. Cytotoxin was positive for 45% of patients that had C. difficile on mPCR. 34% of patients that had C. difficile detected on mPCR also had co-pathogens detected. No significant differences were present in symptomatology between cytotoxin positive and negative patients and no significant differences between white blood cell count (Table 1). There was a significant difference in the number of patients treated for the C. difficile between the cytotoxin populations (p-value< 0.05). The average duration of treatment with a negative test was significantly less than for positive cytotoxin test patients (7.5 vs 11 days, p-value< 0.05). Table 1: Comparison of cytotoxin production in pediatric patients with Clostridioides difficile. Conclusion Our results show a significant amount of antibiotic use for patients with cytotoxin negative C. difficile and no differences in symptomatology or white blood cell count based on cytotoxin positivity. Diagnostic stewardship of mPCR tests may be needed to effectively impact this unneeded antibiotic use, specifically the duration. Disclosures All Authors: No reported disclosures

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CORREALTION OF CT CHEST IMAGES WITH THE CLINICAL PRESENTATION IN COVID-19 INFECTION: A CLINICO-RADIOLOGICAL STUDY

10.36106/paripex/9108615 ◽

2020 ◽

pp. 1-3

Author(s):

Uzma Khan ◽

Arindam Ghosh ◽

Vikram Mutneja

Keyword(s):

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

Clinical Presentation ◽

Ct Scanning ◽

Study Patient ◽

P Value ◽

Blood Cell Count ◽

Fever Onset

Aim: The study aimed to evaluate the correlation of CT chest images with the clinical presentation in COVID-19 infection. Methodology: 50 confirmed COVID-19 patients those who were hospitalized were included in the study. Patient history, laboratory results, demographic data, severity, time course of symptoms was recorded. The duration of onset of the symptoms to initial CT scan, fever recordings including duration of onset of fever to CT scanning and white blood counts were recorded along with the CT Scores of each patient. Results: The CT scores were found to have significant correlation with age (r=0.348, p value= 0.046), duration of onset to CT scanning (r=0.654, p value= 0.001), duration of fever onset to CT scanning (r=0.679, p value= 0.001) and white blood cell count (r=0.398, p value= 0.034). Conclusion: We found correlation between the CT scores and Age, duration of onset to Ct scanning, duration of fever onset to Ct scanning and white blood cell count.

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Leukocytosis during cervical preparation with osmotic dilators for dilation and evacuation

SAGE Open Medicine ◽

10.1177/2050312120986731 ◽

2021 ◽

Vol 9 ◽

pp. 205031212098673

Author(s):

Lyndsey S Benson ◽

Jordan Stevens ◽

Elizabeth A Micks ◽

Sarah W Prager

Keyword(s):

Confidence Interval ◽

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

P Value ◽

Second Trimester ◽

Blood Cell Count ◽

Median Increase ◽

Cervical Preparation

Objectives: To describe leukocytosis trends during cervical preparation with osmotic dilators for second-trimester dilation and evacuation procedures, and to determine whether there is a difference in leukocytosis seen with laminaria versus Dilapan-S. Methods: We conducted a retrospective cohort study of 986 women presenting for dilation and evacuation from April 2008 through March 2009 at an outpatient clinic network. We included all procedures at ⩾14 weeks’ gestation where laminaria or Dilapan-S dilators were used for overnight dilation. All women had routine white blood cell testing during the study period. Results: There was a median increase of 2.4 × 103/μL white blood cell count (95% confidence interval 2.2–2.7 × 103/μL) from beginning of cervical preparation to the day of procedure (95% confidence interval and p value). Women receiving laminaria ( n = 805) versus Dilapan-S ( n = 181) had a greater increase in white blood cell count from baseline (median increase 2.7 versus 1.2 × 103/μL, p < 0.001), including when adjusting for age, gestational age, parity, baseline white blood cell count, and number of dilators placed. Conclusion: There is increased leukocytosis during the course of cervical preparation with osmotic dilators, and this is increased with use of laminaria versus Dilapan-S. Rates of clinically recognized infection in second-trimester abortion are low regardless of dilator type used.

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ESTUDIO DE LA VARIACIÓN DE PERFILES HEMATOLÓGICOS DE MURCIÉLAGOS

Revista Mexicana de Mastozoologia ◽

10.22201/ie.20074484e.2016.6.1.216 ◽

2016 ◽

Vol 6 (1) ◽

pp. 8 ◽

Cited By ~ 1

Author(s):

Evaristo Villalba-Alemán ◽

Mariana Muñoz-Romo

Keyword(s):

Blood Cell ◽

Cell Count ◽

White Blood Cell ◽

Valid Species ◽

Systematic Research ◽

Blood Cell Count ◽

Cell Counts ◽

De Formula ◽

Differential White Blood Cell ◽

Available Information

RESUMENLa información básica sobre los perfiles hematológicos de los murciélagos es muy limitada y dispersa. Para este estudio, nos propusimos compilar la información disponible al respecto con el fin de establecer patrones derivados de su análisis. En los murciélagos, el valor medio de hematocrito se encuentra alrededor del 56%, el recuento de glóbulos rojos promedio es de 10 106/µl, el de glóbulos blancos 5,300 cel/µl, la concentración de hemoglobina 17 g/dL y el recuento diferencial de glóbulos blancos es 42% de neutrófilos, 54% de linfocitos, 2% de monocitos, 1% de eosinófilos y 1% de basófilos. La información existente corresponde a sólo 7.3% de las especies conocidas actualmente incluidas en el orden Chiroptera (1,116). En la literatura disponible no parece establecerse una distinción sexual de perfiles hematológicos. En la distribución de la fórmula leucocitaria de la mayoría de las especies estudiadas se observa un predominio linfocitario que recibe el nombre de “fórmula invertida” o “desviación a la derecha”, pese a que en algunas especies se puede observar una fórmula leucocitaria con predominio de neutrófilos, lo que se denomina en hematología humana “fórmula hacia la izquierda” o “fórmula tipo neutrófilo”. La variación en la fórmula leucocitaria de mamíferos se puede deber a factores funcionales y/o genéticos. La información disponible para 81 especies resulta escasa para un grupo tan diverso como el de los murciélagos, por lo cual no es posible establecer patrones claros e inequívocos. Investigaciones profundas y detalladas son primordiales para ello, a fin de identificar los factores asociados a la variación en los parámetros hematológicos.Palabras clave: Chiroptera, eritrocito, hematocrito, hematología, hemoglobina.ABSTRACTGeneral information on hematological profiles of bats is very limited and scattered. For this study, our goal was to compile the available information on this topic to determine the pattern, if any, derived from its analysis. In bats, the average hematocrit (Hct) level is around 56%, the average red blood cell count (rbc; erythrocytes) is 10 106/µl, the average total white blood cell count (twbc; leukocytes) is 5,300 cel/µl, the hemoglobin is around 17 g/dL, and the averages of differential white blood cell counts (dwbc) are 42% of neutrophils, 54% of lymphocytes, 2% of monocytes, 1% of eosinophils, and 1% of basophils. The available information for bats as a group corresponds only to 7.3% of the currently valid species (1,116). In the available literature, it does not seem to exist a sexual differentiation between hematological profiles. In the distribution of the leucocitarian formula of most species of bats included here it seems to exist an important proportion of lymphocytes, know as “inverted formula” or “right bias”, although in some species it seems to be an important proportion of neutrophils, known as “left bias” or “neutrophil-type formula”. In mammals, the variation in this leucocitarian formula depends on functional or genetic factors. The available information for only 81 species of bats is insufficient for a highly diverse group, thus it is not possible to establish currently unequivocal patterns. Further detailed and systematic research is of paramount importance, to finally determine accurate causes of these values and the maintanance of these trends. Key words: Chiroptera, erythrocyte, hematocrite, hematology, hemoglobin.

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Analysis of Platelet-Rich Plasma Extraction

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967116675272 ◽

2017 ◽

Vol 5 (1) ◽

pp. 232596711667527 ◽

Cited By ~ 60

Author(s):

Jane Fitzpatrick ◽

Max K. Bulsara ◽

Paul Robert McCrory ◽

Martin D. Richardson ◽

Ming Hao Zheng

Keyword(s):

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

Blood Cells ◽

Platelet Rich Plasma ◽

White Blood Cells ◽

Clinical Use ◽

Blood Cell Count ◽

High Concentrations

Background: Platelet-rich plasma (PRP) has been extensively used as a treatment in tissue healing in tendinopathy, muscle injury, and osteoarthritis. However, there is variation in methods of extraction, and this produces different types of PRP. Purpose: To determine the composition of PRP obtained from 4 commercial separation kits, which would allow assessment of current classification systems used in cross-study comparisons. Study Design: Controlled laboratory study. Methods: Three normal adults each donated 181 mL of whole blood, some of which served as a control and the remainder of which was processed through 4 PRP separation kits: GPS III (Biomet Biologics), Smart-Prep2 (Harvest Terumo), Magellan (Arteriocyte Medical Systems), and ACP (Device Technologies). The resultant PRP was tested for platelet count, red blood cell count, and white blood cell count, including differential in a commercial pathology laboratory. Glucose and pH measurements were obtained from a blood gas autoanalyzer machine. Results: Three kits taking samples from the “buffy coat layer” were found to have greater concentrations of platelets (3-6 times baseline), while 1 kit taking samples from plasma was found to have platelet concentrations of only 1.5 times baseline. The same 3 kits produced an increased concentration of white blood cells (3-6 times baseline); these consisted of neutrophils, leukocytes, and monocytes. This represents high concentrations of platelets and white blood cells. A small drop in pH was thought to relate to the citrate used in the sample preparation. Interestingly, an unexpected increase in glucose concentrations, with 3 to 6 times greater than baseline levels, was found in all samples. Conclusion: This study reveals the variation of blood components, including platelets, red blood cells, leukocytes, pH, and glucose in PRP extractions. The high concentrations of cells are important, as the white blood cell count in PRP samples has frequently been ignored, being considered insignificant. The lack of standardization of PRP preparation for clinical use has contributed at least in part to the varying clinical efficacy in PRP use. Clinical Relevance: The variation of platelet and other blood component concentrations between commercial PRP kits may affect clinical treatment outcomes. There is a need for standardization of PRP for clinical use.

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Value of white blood cell count with differential in the acute diabetic foot infection

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-86-5-224 ◽

1996 ◽

Vol 86 (5) ◽

pp. 224-227 ◽

Cited By ~ 44

Author(s):

DG Armstrong ◽

TA Perales ◽

RT Murff ◽

GW Edelson ◽

JG Welchon

Keyword(s):

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

Diabetic Foot ◽

Polymorphonuclear Leukocyte ◽

White Cell ◽

Blood Cell Count ◽

Diabetic Foot Infection ◽

Cell Counts

The authors reviewed the admission leukocyte indices of 338 consecutive admissions (203 males, 135 females, mean age of 60.2 +/- 12.9 years) with a primary diagnosis of diabetic foot infection in a multicenter retrospective study. The mean white blood cell count on admission for all subjects studied was calculated at 11.9 +/- 5.4 x 103 cells/mm3. Of all white blood cell counts secured for patients admitted with a diabetic foot infection, 56% (189 out of 338) were within normal limits. The average automated polymorphonuclear leukocyte percentage was calculated at 71.4 +/- 11.1% (normal range 40% to 80%). Normal polymorphonuclear leukocyte values were present in 83.7% of subjects. The authors stress that the diagnosis of a diabetic pedal infection is made primarily on the basis of clinical signs and symptoms, and that a normal white cell count and white cell differential should not deter the physician from taking appropriate action to mitigate the propagation of a potentially limb-threatening pedal infection.

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Agranulocytosis Induced by Vancomycin or Ticarcillin/Clavulanate

Annals of Pharmacotherapy ◽

10.1177/106002809703101109 ◽

1997 ◽

Vol 31 (11) ◽

pp. 1321-1324 ◽

Cited By ~ 7

Author(s):

Delbert L Mandl ◽

Mark W Garrison ◽

Samuel D Palpant

Keyword(s):

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

White Blood Cells ◽

Blood Cell Count ◽

Cell Counts ◽

Long Term Treatment ◽

Term Administration

OBJECTIVE: To reacquaint clinicians with a reportedly rare adverse event of agranulocytosis occurring after long-term administration of vancomycin and ticarcillin/clavulanate, with a subsequent review of other reported cases in the literature. CASE SUMMARY: A 45-year-old white woman with spina bifida developed agranulocytosis (2.7 × 103/mm3 white blood cells with only 3% polymorphonuclear leukocytes and no reported eosinophils or basophils) after long-term administration of vancomycin and ticarcillin/clavulanate for decubitus ulcers and chronic osteomyelitis. Consequently, the cell counts rebounded rapidly on discontinuation of both medications and returned to normal within 1 week. DISCUSSION: The incidence of vancomycin-associated neutropenia is presumably rare, but the increased use of vancomycin may disclose a more frequent occurrence. It is suggested that the mechanism for the reaction is immunologically mediated, yet this remains unclear. Although it is difficult to determine the causative agent in this case, vancomycin was most suspect clinically. Ticarcillin/clavulanate is less likely because our patient has since been readmitted and treated with oxacillin, imipenem/cilastatin, and amoxicillin/clavulanate without affecting the white blood cell count. In that regard, it could be reasoned that an immunologic reaction to ticarcillin would have resulted in a similar outcome with other penicillins. CONCLUSIONS: This case serves as a reminder to clinicians that patients receiving long-term treatment with vancomycin should have their white blood cell count monitored at least weekly.

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The incidence and timing of leukocyte overshoot after pegfilgrastim administration

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155218769140 ◽

2018 ◽

Vol 25 (4) ◽

pp. 869-874 ◽

Cited By ~ 1

Author(s):

Eiseki Usami ◽

Michio Kimura ◽

Mina Iwai ◽

Makiko Go ◽

Hiroki Asano ◽

...

Keyword(s):

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

Reference Value ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Blood Cell Count ◽

Cell Counts ◽

Stimulating Factor

Introduction Pegfilgrastim is a PEGylated formulation of filgrastim with a long half-life. It is highly convenient and less burdensome for patients. However, white blood cell count may temporarily increase after administration; in particular, a leukocyte overshoot may be observed. The present study retrospectively examined the incidence and timing of leukocyte overshoot after pegfilgrastim administration. Patients and methods Fifty-five patients (118 occasions of pegfilgrastim) were evaluated. Leukocyte overshoot was defined as white blood cell count ≥10,000/mm3 exceeding the reference value. Results Leukocyte overshoot was observed in 71.2% (84/118) occasions, in 76.4% (42/55) patients. The maximum white blood cell count ≥30,000/mm3 was observed in 30.5% (36/118) occasions in 45.5% (25/55) patients and was observed in 39.3% (33/84) occasions on day 1 after pegfilgrastim administration and 26.2% (22/84) on day 2. Leukocyte overshoot has been observed in only 23.1% (9/39) patients administered with normal granulocyte colony-stimulating factor. However, there were no patients with white blood cell counts ≥30,000/mm3. Conclusion There was a higher frequency of occurrence of leukocyte overshoot in response to pegfilgrastim than in response to normal granulocyte colony-stimulating factor. High incidence of leukocyte overshoot was observed when blood was collected 1–2 days after administration of pegfilgrastim. It is important for patients to understand the characteristics of pegfilgrastim by conducting pharmaceutical guidance.

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