Avoiding Spurious Low Platelet Counts by Redrawing Specimens with First Time Low Platelet Counts

2021 ◽  
pp. 1-4
Author(s):  
Randall Craver
Keyword(s):  
Platelet Counts ◽  
First Time

Pregnancy in Essential Thrombocythemia (ET): Experience with 40 Pregnancies.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1511-1511
Author(s):  
Eeva Juvonen ◽  
Riitta Niittyvuopio ◽  
Risto Kaaja ◽  
Kalevi Oksanen ◽  
Heikki Hallman ◽  
...  
Keyword(s):  
Live Birth ◽  
Pregnancy Loss ◽  
Birth Rate ◽  
Live Birth Rate ◽  
First Trimester ◽  
Common Complication ◽  
Platelet Counts ◽  
Complicated Pregnancy ◽  
First Time ◽  
In Pregnancy

Abstract 40 pregnancies of 16 women with ET were analyzed retrospectively. In 6 patients ET was diagnosed before the first pregnancy. In 10 patients thrombocytosis was detected for the first time during a pregnancy, and the diagnosis of ET was confirmed in the median of 17 months from the delivery. Of the pregnancies 45% (18/40) were complicated, 55% (22/40) uncomplicated, and 63% (25/40) resulted in live birth. 9/16 women had at least one complicated pregnancy. The most common complication was spontaneous abortion during the first trimester, seen in 33% of all pregnancies and comprising 72% of all complications. 2 intrauterine fetal deaths occurred at weeks 22 and 28. 3 pregnancies were complicated by eclampsia or pre-eclampsia. The non-pregnancy-related symptoms of ET or platelet counts before conception or during pregnancy did not correlate with the risk of complications. The median of maximum platelet counts during the first trimester in 16 pregnancies resulting in live birth was 757 x 109/l (255 – 1561 x 109/l) and in 13 pregnancies ending in pregnancy loss 835 x 109/l (697 – 1525 x 109/l) (p=0.25). The intrauterine fetal deaths occurred with platelet counts 553 and 574 x 109/l. In patients with eclampsia or pre-eclampsia the platelet counts were normal at the onset of the symptoms. Only 2 patients had other ET-related symptoms during pregnancy. 9 patients had ET-related symptoms before or between the pregnancies. In 4 of them the pregnancies were uncomplicated. Treatment for ET was or had been given to 11/16 (67%) women in 13 pregnancies either during the pregnancy or before conception or both. Acetylsalicylic acid (ASA) was given in 10 pregnancies of 9 patients. 2 continued with ASA throughout the pregnancy. In 7 patients ASA was started at 4–27 weeks of gestation, in 4 of them during the first trimester. 7 patients had received platelet lowering drugs before conception. 5 were on interferon (IFN) before conception; 3 of them switched over to ASA after conception, one continued with IFN after a 4-week break from week 15 onwards, one continued with IFN throughout the pregnancy. Both patients on IFN during the pregnancy received also ASA. 2 women had been treated with busulphan before conception; one because of previous recurrent miscarriages successfully before two pregnancies, and the other with no pregnancy planning 26 months before the conception. Pregnancy complications occurred in 18/27 (67%) pregnancies in women without any treatment and in 0/13 pregnancies in those with treatment before or during the pregnancy (p<0.001). The live-birth rate in the treated patients (13/13 pregnancies, 100%) was higher than that in the untreated patients (12/27 pregnancies, 44%)(p<0.001). 8/8 pregnancies with ASA alone resulted in live birth (difference from untreated patients p=0.01). Conclusion: Nearly half of the pregnancies in patients with ET were complicated and one third resulted in pregnancy loss. Treatment with ASA alone during pregnancy or platelet-lowering drugs before or during pregnancy was associated with lower risk of complications.

Clinical improvement with a novel CD20 mAb, ofatumumab, in fludarabine-refractory chronic lymphocytic leukemia (CLL) also refractory to alemtuzumab or with bulky lymphadenopathy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7043-7043 ◽  
Author(s):  
T. J. Kipps ◽  
A. Österborg ◽  
J. Mayer ◽  
S. Stilgenbauer ◽  
A. Hellmann ◽  
...  
Keyword(s):  
Treatment Options ◽  
Single Agent ◽  
Lymphocytic Leukemia ◽  
Rapid Improvement ◽  
Disease Symptoms ◽  
Platelet Counts ◽  
Heavily Pretreated ◽  
Independent Review ◽  
First Time

7043 Background: Patients (pts) with CLL refractory tofludarabine and alemtuzumab (double-refractory, DR) or refractory to fludarabine with bulky (>5 cm) lymphadenopathy (bulky fludarabine-refractory, BFR) have a poor prognosis. Ofatumumab is a human mAb specific for a distinctive small-loop epitope of CD20 that appears more potent than rituximab in eliciting complement-dependent lysis of B cells in vitro. We report, for the first time, results from the planned interim analysis of the clinical benefit observed in pts with DR or BFR CLL treated with ofatumumab in an international pivotal clinical study. Methods: Pts with DR or BFR CLL received 8 weekly then 4 monthly ofatumumab infusions (Dose 1, 300 mg; Doses 2–12, 2,000 mg). Primary endpoint was overall response rate (ORR; 1996 NCI-WG criteria), as assessed by an Independent Review Committee, over 24 wks. Results: Of 138 treated pts (DR: N = 59; BFR: N = 79; median age 64 and 62 yrs, respectively), 63% had Rai stage III/IV disease at screening. Pts had a median of 5 prior therapies. ORR (99% CI) was 58% (40, 74%) in the DR and 47% (32, 62%) in the BFR groups, and median overall survival (95% CI) was 13.7 mo (9.4, NR) and 15.4 mo (10.2, 20.2), respectively. Resolution of disease symptoms (maintained for ≥2 mo) were observed in a large proportion of pts (Table), including in pts considered nonresponders by NCI-WG criteria. Improvements in hematologic values were also observed in some pts with abnormal baseline values, particularly for platelet counts. Pts with thrombocytopenia at baseline (n = 73) experienced sustained increases in median platelet counts from 65 × 109/L to over 100 × 109/L by Wk 8; a similar pattern of rapid improvement was observed in Hgb values. Conclusions: Ofatumumab as single-agent achieves high ORR, and improves disease symptoms and hematologic parameters in heavily pretreated pts with DR and BFR disease who lack standard treatment options. [Table: see text] [Table: see text]

scholarly journals Longitudinal laboratory testing tied to PCR diagnostics in COVID-19 patients reveals temporal evolution of distinctive coagulopathy signatures

2020 ◽  
Author(s):  
Colin Pawlowski ◽  
Tyler Wagner ◽  
Arjun Puranik ◽  
Karthik Murugadoss ◽  
Liam Loscalzo ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Laboratory Testing ◽  
Diagnostic Testing ◽  
Temporal Trends ◽  
Disseminated Intravascular Coagulopathy ◽  
Platelet Counts ◽  
Fine Grained ◽  
Intravascular Coagulopathy ◽  
First Time ◽  
Observation Period

Temporal inference from laboratory testing results and their triangulation with clinical outcomes as described in the associated unstructured text from the provider notes in the Electronic Health Record (EHR) is integral to advancing precision medicine. Here, we studied 181 COVIDpos and 7,775 COVIDneg patients subjected to 1.3 million laboratory tests across 194 assays during a two-month observation period centered around their SARS-CoV-2 PCR testing dates. We found that compared to COVIDneg at the time of clinical presentation and diagnostic testing, COVIDpos patients tended to have higher plasma fibrinogen levels and similarly low platelet counts, with approximately 25% of patients in both cohorts showing outright thrombocytopenia. However, these measures show opposite longitudinal trends as the infection evolves, with declining fibrinogen and increasing platelet counts to levels that are lower and higher compared to the COVIDneg cohort, respectively. Our EHR augmented curation efforts suggest a minority of patients develop thromboembolic events after the PCR testing date, including rare cases with disseminated intravascular coagulopathy (DIC), with most patients lacking the platelet reductions typically observed in consumptive coagulopathies. These temporal trends present, for the first time, fine-grained resolution of COVID-19 associated coagulopathy (CAC), via a digital framework that synthesizes longitudinal lab measurements with structured medication data and neural network-powered extraction of outcomes from the unstructured EHR. This study demonstrates how a precision medicine platform can help contextualize each patients specific coagulation profile over time, towards the goal of informing better personalization of thromboprophylaxis regimen.

scholarly journals Thrombocytopenia in Dengue Hemorrhagic Fever

2019 ◽  
Vol 32 (3-4) ◽  
pp. 75-83
Author(s):  
Sunarto Sunarto ◽  
Sutaryo Sutaryo
Keyword(s):  
Phase Contrast ◽  
Hemorrhagic Fever ◽  
The Other ◽  
Who Criteria ◽  
Thrombocyte Count ◽  
Platelet Counts ◽  
Hemagglutination Inhibition Test ◽  
Contrast Microscope ◽  
Almost All ◽  
First Time

According to WHO thrombocytopenia is one of the diagnostic criteria of DHF. On the other hand many studies have reported DHF cases without evidence of thrombocytopenia. One hundred fifty nine DHF out of485 suspected cases were assessed for their platelet counts. Diagnosis of DHF was established based on the WHO criteria, and confirmed by the hemagglutination inhibition test. The platelet counts were done serially and intensively by phase contrast microscope from the first day of hospitalization until the patient's discharge. In 77 patients thrombocytopenia appeared for the first time during hospitalization. Mild thrombocytopenia appeared in almost all of these cases before thrombocyte count of 100,000 reached. Seventy two patients had shown thrombocytopenia on the day of admission. No thrombocytopenia was found on the second day of illness, the earliest time of the detection of thrombocytopenia was on the Jrri and the latest was on the 8th day of illness. Thrombocytopenia lasted 1-5 days. It is concluded that many DHF diagnosis would have been missed if the thrombocyte investigation had not been done serially and intensively. Mild thrombocytopenia in DHF suspected patients should call attention to do platelet investigation intensively in those cases.

Annulate lamellae in the Sertoli cells of guinea pig testis after unilateral torsion of the spermatic cord

1984 ◽  
Vol 42 ◽  
pp. 196-197
Author(s):  
J. Chakraborty ◽  
A. P. Sinha Hikim ◽  
J. S. Jhunjhunwala
Keyword(s):  
Sertoli Cells ◽  
Guinea Pigs ◽  
Spermatic Cord ◽  
Present Report ◽  
Cell Types ◽  
Annulate Lamellae ◽  
Spermatogenic Cells ◽  
Electron Microscopic ◽  
Structural Details ◽  
First Time

Although the presence of annulate lamellae was noted in many cell types, including the rat spermatogenic cells, this structure was never reported in the Sertoli cells of any rodent species. The present report is based on a part of our project on the effect of torsion of the spermatic cord to the contralateral testis. This paper describes for the first time, the fine structural details of the annulate lamellae in the Sertoli cells of damaged testis from guinea pigs.One side of the spermatic cord of each of six Hartly strain adult guinea pigs was surgically twisted (540°) under pentobarbital anesthesia (1). Four months after induction of torsion, animals were sacrificed, testes were excised and processed for the light and electron microscopic investigations. In the damaged testis, the majority of seminiferous tubule contained a layer of Sertoli cells with occasional spermatogonia (Fig. 1). Nuclei of these Sertoli cells were highly pleomorphic and contained small chromatinic clumps adjacent to the inner aspect of the nuclear envelope (Fig. 2).

Electron spectroscopic imaging and diffraction

1991 ◽  
Vol 49 ◽  
pp. 706-707
Author(s):  
M. Rühle ◽  
J. Mayer ◽  
J.C.H. Spence ◽  
J. Bihr ◽  
W. Probst ◽  
...  
Keyword(s):  
Materials Science ◽  
Electron Spectroscopic Imaging ◽  
Magnetic Filter ◽  
Magnetic Imaging ◽  
Illumination System ◽  
Probe Size ◽  
Diffraction Patterns ◽  
Fritz Haber ◽  
Koehler Illumination ◽  
First Time

A new Zeiss TEM with an imaging Omega filter is a fully digitized, side-entry, 120 kV TEM/STEM instrument for materials science. The machine possesses an Omega magnetic imaging energy filter (see Fig. 1) placed between the third and fourth projector lens. Lanio designed the filter and a prototype was built at the Fritz-Haber-Institut in Berlin, Germany. The imaging magnetic filter allows energy-filtered images or diffraction patterns to be recorded without scanning using efficient area detection. The energy dispersion at the exit slit (Fig. 1) results in ∼ 1.5 μm/eV which allows imaging with energy windows of ≤ 10 eV. The smallest probe size of the microscope is 1.6 nm and the Koehler illumination system is used for the first time in a TEM. Serial recording of EELS spectra with a resolution < 1 eV is possible. The digital control allows X,Y,Z coordinates and tilt settings to be stored and later recalled.

A Novel TEM Technique for Characterizing As-Grown CVD Diamond Films

1991 ◽  
Vol 49 ◽  
pp. 956-957 ◽  
Author(s):  
Z.L. Wang ◽  
J. Bentley ◽  
R.E. Clausing ◽  
L. Heatherly ◽  
L.L. Horton
Keyword(s):  
Diamond Films ◽  
Chemical Vapor ◽  
Growth Direction ◽  
Dark Field ◽  
Growth Surface ◽  
Specimen Preparation ◽  
Transmission Electron ◽  
Diffraction Patterns ◽  
First Time ◽  
Microstructural Studies

Microstructural studies by transmission electron microscopy (TEM) of diamond films grown by chemical vapor deposition (CVD) usually involve tedious specimen preparation. This process has been avoided with a technique that is described in this paper. For the first time, thick as-grown diamond films have been examined directly in a conventional TEM without thinning. With this technique, the important microstructures near the growth surface have been characterized. An as-grown diamond film was fractured on a plane containing the growth direction. It took about 5 min to prepare a sample. For TEM examination, the film was tilted about 30-45° (see Fig. 1). Microstructures of the diamond grains on the top edge of the growth face can be characterized directly by transmitted electron bright-field (BF) and dark-field (DF) images and diffraction patterns.

A microscopic marker experiment study on high temperature oxidation of Ni-Al alloy

1986 ◽  
Vol 44 ◽  
pp. 514-515
Author(s):  
Shou-kong Fan
Keyword(s):  
Transport Mechanism ◽  
High Temperature Oxidation ◽  
Transverse Section ◽  
Al Alloy ◽  
Metal Interface ◽  
Electron Microscopic ◽  
Temperature Oxidation ◽  
Analytical Electron ◽  
Microscopic Studies ◽  
First Time

Transmission and analytical electron microscopic studies of scale microstructures and microscopic marker experiments have been carried out in order to determine the transport mechanism in the oxidation of Ni-Al alloy. According to the classical theory, the oxidation of nickel takes place by transport of Ni cations across the scale forming new oxide at the scale/gas interface. Any markers deposited on the Ni surface are expected to remain at the scale/metal interface after oxidation. This investigation using TEM transverse section techniques and deposited microscopic markers shows a different result,which indicates that a considerable amount of oxygen was transported inward. This is the first time that such fine-scale markers have been coupled with high resolution characterization instruments such as TEM/STEM to provide detailed information about evolution of oxide scale microstructure.

Direct imaging of charge transfer

1996 ◽  
Vol 54 ◽  
pp. 680-681
Author(s):  
Yimei Zhu ◽  
J. Tafto
Keyword(s):  
Charge Transfer ◽  
Electron Diffraction ◽  
Scattering Amplitude ◽  
High Temperature Superconductors ◽  
Charge Carriers ◽  
Image Charge ◽  
Net Charge ◽  
Long Time ◽  
Electron Holes ◽  
First Time

The electron holes confined to the CuO2-plane are the charge carriers in high-temperature superconductors, and thus, the distribution of charge plays a key role in determining their superconducting properties. While it has been known for a long time that in principle, electron diffraction at low angles is very sensitive to charge transfer, we, for the first time, show that under a proper TEM imaging condition, it is possible to directly image charge in crystals with a large unit cell. We apply this new way of studying charge distribution to the technologically important Bi2Sr2Ca1Cu2O8+δ superconductors.Charged particles interact with the electrostatic potential, and thus, for small scattering angles, the incident particle sees a nuclei that is screened by the electron cloud. Hence, the scattering amplitude mainly is determined by the net charge of the ion. Comparing with the high Z neutral Bi atom, we note that the scattering amplitude of the hole or an electron is larger at small scattering angles. This is in stark contrast to the displacements which contribute negligibly to the electron diffraction pattern at small angles because of the short g-vectors.

Recent developments in low-voltage SEM of polymers

1993 ◽  
Vol 51 ◽  
pp. 866-867
Author(s):  
S.J. Krause ◽  
W.W. Adams
Keyword(s):  
Low Voltage ◽  
Chromatic Aberration ◽  
Thermal Electron ◽  
Analytical Technique ◽  
Recent Developments ◽  
Beam Currents ◽  
New Generation ◽  
First Time ◽  
Voltage Scanning ◽  
Beam Damage

Over the past decade low voltage scanning electron microscopy (LVSEM) of polymers has evolved from an interesting curiosity to a powerful analytical technique. This development has been driven by improved instrumentation and in particular, reliable field emission gun (FEG) SEMs. The usefulness of LVSEM has also grown because of an improved theoretical and experimental understanding of sample-beam interactions and by advances in sample preparation and operating techniques. This paper will review progress in polymer LVSEM and present recent results and developments in the field.In the early 1980s a new generation of SEMs produced beam currents that were sufficient to allow imaging at low voltages from 5keV to 0.5 keV. Thus, for the first time, it became possible to routinely image uncoated polymers at voltages below their negative charging threshold, the "second crossover", E2 (Fig. 1). LVSEM also improved contrast and reduced beam damage in sputter metal coated polymers. Unfortunately, resolution was limited to a few tenths of a micron due to the low brightness and chromatic aberration of thermal electron emission sources.

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