scholarly journals Cerebrospinal fluid cell count variability is a major confounding factor in external ventricular drain-associated infection surveillance diagnostics: a prospective observational study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Marcus Bådholm ◽  
Jonas Blixt ◽  
Martin Glimåker ◽  
Anders Ternhag ◽  
Jonas Hedlund ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cell Count ◽  
External Ventricular Drain ◽  
Homogeneous Distribution ◽  
National Guidelines ◽  
Suspected Infection ◽  
Paired Samples ◽  
Cell Counts ◽  
Lactate Levels ◽  
The Relationship

Abstract Background External ventricular drain (EVD)-related infections (EVDIs) are feared complications that are difficult to rapidly and correctly diagnose, which can lead to unnecessary treatment with broad-spectrum antibiotics. No readily available diagnostic parameters have been identified to reliably predict or identify EVDIs. Moreover, intraventricular hemorrhage is common and affect cerebrospinal fluid (CSF) cellularity. The relationship between leukocytes and erythrocytes is often used to identify suspected infection and triggers the use of antibiotics pending results of cultures, which may take days. Cell count based surveillance diagnostics assumes a homogeneous distribution of cells in the CSF. Given the intraventricular sedimentation of erythrocytes on computed tomography scans this assumption may be erroneous and could affect diagnostics. Aims To evaluate the consistency of cell counts in serially sampled CSF from EVDs, with and without patient repositioning, to assess the effect on infection diagnostics. Methods We performed a prospective single-center study where routine CSF sampling was followed by a second sample after 10 min, allocated around a standard patient repositioning, or not. Changes in absolute and pairwise cell counts and ratios were analyzed, including mixed regression models. Results Data from 51 patients and 162 paired samples were analyzed. We observed substantial changes in CSF cellularity as the result of both resampling and repositioning, with repositioning found to be an independent predictor of bidirectional cellular change. Glucose and lactate levels were affected, however clinically non-significant. No positive CSF cultures were seen during the study. Thirty percent (30%) of patients changed suspected EVDI status, as defined by the cell component of local and national guidelines, when resampling after repositioning. Conclusions CSF cell counts are not consistent and are affected by patient movement suggesting a heterogeneity in the intraventricular space. The relationship between leukocytes and erythrocytes was less affected than absolute changes. Importantly, cell changes are found to increase with increased cellularity, often leading to changes in suspected EVDI status. Faster and more precise diagnostics are needed, and methods such as emerging next generation sequencing techniques my provide tools to more timely and accurately guide antibiotic treatment. Trial Registration NCT04736407, Clinicaltrials.gov, retrospectively registered 2nd February 2021.

Influence of elevated somatic cell count on casein distribution and cheese-making

1980 ◽  
Vol 47 (3) ◽  
pp. 393-400 ◽  
Author(s):  
Ali E. Ali ◽  
Anthony T. Andrews ◽  
Gordon C. Cheeseman
Keyword(s):  
Somatic Cell ◽  
Cell Count ◽  
Somatic Cell Count ◽  
Cheese Making ◽  
Commercial Practice ◽  
Cell Counts ◽  
Bulk Milk ◽  
Soluble Phase ◽  
Relationship Of ◽  
The Relationship

SummaryThe effects of increased somatic cell count, whether caused by infection or by experimental infusion of bacterial endotoxin, on the distribution in milk of caseins between the micellar and soluble forms were investigated. The relationship of somatic cell count to some cheese-making parameters was also studied. With quite modestly elevated cell counts (2–3 × 106/ml) increases of up to 37% in total casein in the soluble phase were observed, most of which was contributed by β-casein, while κ- and αs1-caseins increased only slightly. With storage at 4°C, the concentrations of all the caseins, Ca and phosphate in the soluble phase increased substantially during the first 48 h, but this was followed by a slight decline on further storage. Rennet clotting time, losses of fat in whey, curd moisture, and losses in curd yield and rigidity were all greater the higher the somatic count. Clear differences were detectable in these parameters between milks of very low cell count (e.g. 5 × 104 cells/ml) and milks with counts more typical of those found in bulk supplies (e.g. about 5 × 105 cells/ml). If these findings can be reproduced in commercial practice even a modest reduction in bulk milk somatic cell counts might be expected to bring definite benefits.

RELATIONSHIPS BETWEEN SPEED OF MILKING AND SOMATIC CELL COUNT AND PRODUCTION IN HOLSTEINS

1983 ◽  
Vol 63 (4) ◽  
pp. 781-789 ◽  
Author(s):  
R. K. MOORE ◽  
J. E. MOXLEY ◽  
B. W. KENNEDY ◽  
E. B. BURNSIDE
Keyword(s):  
Somatic Cell ◽  
Cell Count ◽  
Milk Yield ◽  
Somatic Cell Count ◽  
Genetic Correlations ◽  
Heritability Estimate ◽  
Phenotypic Correlations ◽  
Cell Counts ◽  
Holstein Friesian ◽  
The Relationship

Milking speed data were obtained for 2604 Holstein-Friesian cows, identified by sire, in test herds located in Quebec and Ontario. Milk samples were collected from each cow and analyzed for somatic cell count. Completed or projected lactation production records were available for this sample of cows. Two-minute yield and total milking time were adjusted for the effect of milk yield at sampling and the raw cell counts were transformed to the natural log scale. Sire and error variances were obtained by maximum likelihood (ML) methods and used to estimate heritabilities of and correlations between traits. The heritability estimate for the adjusted 2-min. yield, 0.23, was higher than that for the adjusted total milking time (0.13), with the estimates for the two unadjusted measures being intermediate (0.18). The phenotypic correlations between milking speed and somatic cell count were small. However, there were two distinct linear phases to the relationship between the adjusted 2-min yield and cell count. Small but significant phenotypic correlations were observed between unadjusted measures of milking speed and lactation production (0.11–0.22); however, correlations were not significant when adjustments were made for the milk yield at sampling. Genetic correlations between milking speed and somatic cell count were moderate to large and indicated an antagonistic relationship between faster milking speed and cell count. Also, the genetic correlations suggested some antagonism between increasing 2-min yield and lactation production, while the relationship between lactation traits and milking time was small. Key words: Milking speed, somatic cell count, correlations, heritabilities, Holsteins

The cell count of milk in relation to milk yield

1978 ◽  
Vol 45 (1) ◽  
pp. 5-14 ◽  
Author(s):  
A. Meijering ◽  
F. H. J. Jaartsveld ◽  
M. W. A. Verstegen ◽  
M. J. M. Tielen
Keyword(s):  
Cell Count ◽  
Milk Yield ◽  
Yield Losses ◽  
Clinical Forms ◽  
Cell Counts ◽  
The Relationship

SummaryQuarter-milk cell counts and milk yields from 1000 cows in the province of Noord-Brabant were obtained over a 12-month period. The data from 933 animals, mainly heifers, were used to examine statistically the relationship between cell counts, as a criterion for sub-clinical forms of mastitis, and milk yield. Losses in milk were assessed by quarter, by pairs of quarters and by cow. The conclusions were that the losses in milk due to sub-clinical forms of mastitis, as indicated by cell count, can be substantial. The existence of a compensating increase in milk yield from a healthy gland, in response to the loss of milk from a neighbouring quarter with raised cell count, could not be demonstrated.

THE INFLUENCE OF THE WORKING FACTOR AND CELL CONTENT ON THE PRECISION OF MICROSCOPIC COUNTS OF MILK SOMATIC CELLS1

1966 ◽  
Vol 29 (2) ◽  
pp. 49-52 ◽  
Author(s):  
R. Schneider ◽  
D. E. Jasper
Keyword(s):  
Least Squares ◽  
Cell Count ◽  
Inverse Relationship ◽  
Least Squares Method ◽  
The Other ◽  
Major Portion ◽  
Cell Content ◽  
Cell Counts ◽  
Count Range ◽  
The Relationship

Summary Variations in precision of the Breed method for cell counts in milk were investigated by utilizing different working factors (WF) for the same smear and by using the same WF over a major portion of the probable cell count range. A significant inverse relationship was found between precision and the WF. With a constant WF on the other hand, the precision of the count increased very significantly as the actual cell count increased. Formulas showing the relationship between the expected high and low for any given cell count were computed via the least squares method for a WF of 20,000. Evidence was presented that a WF of 5,000 or below would be necessary when a good estimate of cell content is important.

scholarly journals Thai national guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2010

2010 ◽  
Vol 4 (4) ◽  
pp. 515-528 ◽  
Author(s):  
Somnuek Sungkanuparph ◽  
Wichai Techasathit ◽  
Chitlada Utaipiboon ◽  
Sanchai Chasombat ◽  
Sorakij Bhakeecheep ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Health Care Policy ◽  
Treatment Success ◽  
Antiretroviral Drugs ◽  
Cd4 T Cell ◽  
National Guidelines ◽  
Cell Counts ◽  
Long Term Treatment ◽  
Cd4 T Cell Count

Abstract In Thailand, more than 150,000 patients are currently treated with antiretroviral drugs under the support of the National AIDS Program (NAP). The appointed Adults and Adolescents Committee consisted of 28 members who are experts in HIV research, patient care or health care policy. Relevant published literature, guidelines, and the most recent relevant clinical trials presented internationally were reviewed. Several peer review and clinical studies conducted in Thailand were included in the review process. Special considerations for patients with co-infection of tuberculosis or hepatitis B were incorporated. Appropriate cut-off of CD4+ T-cell counts when to commence ART among Thai patients have been considered. It is now recommended to start ART at CD4+ T-cell count <350 cells/mm3. For treatment-naive patients, the preferred initial therapy is a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen containing lamivudine plus zidovudine or tenofovir. Stavudine will be phased out in a two-year plan at the national program level. Viral load and CD4+ T-cell counts should be monitored at least once and twice a year. To achieve long-term treatment success, enhancing adherence together with the proper management of antiretroviral-related toxicity is critical. In summary, the major changes from the Thai 2008 guidelines include commencing ART earlier. ART is recommended regardless of CD4+ T cell count if patients have an indication to treat their HBV co-infection. Preferred first regimen uses AZT or TDF, not d4T as the NRTI-backbone. Furthermore, efavirenz is now considered a preferred NNRTI, along with nevirapine.

METHODS FOR EVALUATING FROST HARDINESS IN ALFALFA

1975 ◽  
Vol 55 (3) ◽  
pp. 823-826 ◽  
Author(s):  
P. D. WALTON
Keyword(s):  
Low Temperature ◽  
Cell Count ◽  
Living Cell ◽  
Temperature Treatment ◽  
Regression Coefficients ◽  
Tissue Impedance ◽  
Low Temperature Treatment ◽  
Cell Counts ◽  
Medicago Sativa L ◽  
The Relationship

Root tissue excised from alfalfa cultivars (Medicago sativa L. and M. media Pers.) was used to determine relationships between impedance, living cell count and duration of low temperature treatment for cold-conditioned material. Correlations exist between all combinations of these three characters. For the cultivars studied, differences were found to exist between regression coefficients for the relationship between tissue impedance and living cell counts when tissue treated with sucrose was compared with tissue receiving no sucrose. The use of sucrose together with cold conditioning was also shown to be effective in detecting small differences in impedance between clones.

scholarly journals CD4 T Cell Count in Newly diagnosed PTB Patients With Reference to their HIV Sero status

2017 ◽  
Vol 15 (2) ◽  
pp. 32-39
Author(s):  
Piyush Rajbhandari ◽  
Shyamal Kumar Bhattacharya ◽  
Rajendra Gurung ◽  
Nimesh Poudyal ◽  
Bickram Pradhan
Keyword(s):  
T Cells ◽  
Cell Count ◽  
Tertiary Care ◽  
Healthy Population ◽  
Care Hospital ◽  
National Guidelines ◽  
Infected Population ◽  
Cell Counts ◽  
The Mean ◽  
Cd4 Cell

Introduction: CD4 and CD8 T cells facilitate the containment of tuberculosis (TB) and has been postulated that there will be changes in their level in patients with TB. This study was carried out to analyze the CD4 cell counts in pulmonary tuberculosis (PTB) patients with reference to their HIV status.Methods: A cross-sectional study was conducted at the Department of Microbiology of a tertiary care hospital of eastern Nepal from May 2012 to April 2013. A total of 160 individuals, 40 each in the PTB, PTB/HIV, HIV and healthy population were included after obtaining informed consent. PTB and HIV diagnosis was made according to national guidelines. CD4 T cells were analyzed using a BD FACS Count Cytometer. Data were entered in Microsoft Excel 2007 and analyzed using SPSS version 11.7.Results: The mean absolute CD4 cells in PTB patient were 562.20 ± 197.3 cells/ul, which was a clear reduction (p < 0.001) when compared to the healthy population of this area (786.30 ± 239.17 cells/ul). There was significant decrease in the CD4 level among the HIV/TB patient (123.70 ± 99.4 cells/ul) as compared to PTB patient without HIV (p < 0.001). The study also noted that the mean CD4 cell level among HIV infected population (249.68 cells/ul) was higher compared to the HIV/TB co-infected population (p < 0.05).Conclusion: CD4 cell count can reflect the degree of immunosuppression in PTB patient irrespective of their HIV status but it cannot predict the disease severity in PTB patient.  

scholarly journals Somatic cell count and chemical composition of milk in naturally BLV-infected cows with different phenotypes of blood leukocyte acid phosphatase

2006 ◽  
Vol 49 (1) ◽  
pp. 17-28
Author(s):  
B. Bojarojć-Nosowicz ◽  
E. Kaczmarczyk
Keyword(s):  
Acid Phosphatase ◽  
Somatic Cell ◽  
Cell Count ◽  
Somatic Cell Count ◽  
First Trimester ◽  
Milk Composition ◽  
Blood Leukocytes ◽  
Cell Counts ◽  
Blood Leukocyte ◽  
The Relationship

Abstract. Effectiveness of the methods applied to control mastitis is low. Therefore, indices are sought which could improve cow immunity to udder pathogens. The aim of the study was to determine the relationship between the polymorphism of blood leukocyte acid phosphatase (AcP), BLV infection, the somatic cell counts and the milk composition in the first trimester of lactation. Studies were performed on a population of 65 Black-and-White cows, aged 3–6 years, from a leukemia-dominated herd. Enzootic bovine leukemia was diagnosed with ELISA and PCR tests. The following analyses were performed: the contents of total protein, lactose, dry matter, somatic cell count in milk as well as microbiological analyses. The obtained results indicate the occurrence of an association between a natural BLV-infection and mammary gland secretion disturbances in cows, whereas the relationship with the acid phosphatase polymorphism is not explicit. The obtained results encourage the continuation of studies into the role of blood leukocytes AcP in the pathogenesis of mastitis.

Establishing a Nucleated Count Reflex Trigger for Performing Cell Differential on Cerebrospinal Fluid in Pediatric Patients

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S9-S10
Author(s):  
Brooj Abro ◽  
Ronald Jackups
Keyword(s):  
Cerebrospinal Fluid ◽  
Cell Count ◽  
Peripheral Blood ◽  
Lymphoblastic Leukemia ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Turnaround Time ◽  
Cns Involvement ◽  
Cell Counts ◽  
Unnecessary Testing

Abstract Introduction Analysis of cerebrospinal fluid (CSF) assists in the diagnosis of several disease processes affecting the central nervous system (CNS). Nucleated cell (NC) count and cell differential are two important components of laboratory testing performed to analyze CSF samples. These tests can help diagnose conditions such as infection, inflammation, and malignancy involving the CNS; however, the cell differential, performed manually on a cytospin, is labor-intensive and may divert laboratory resources. Currently, the laboratory at our tertiary care pediatric hospital performs both NC count and cell differential on all specimens submitted for CSF cell count analysis. We hypothesized that when the NC count is low (&lt;10/mcl), performing manual cell differential does not provide clinically meaningful information and leads to unnecessary testing, increasing the turnaround time and decreasing precision. In this study, we investigated the utility of performing a manual differential on CSF when the NC count is ≤10/mcl and the need to establish reflex criteria for performing a cell differential. Methods Data were extracted from our electronic medical record database. We searched for all CSF samples that were submitted to our pediatric hospital’s laboratory for cell count analysis from September 2019 to January 2020. NC count, red blood cell (RBC) count, and number of cells available for differential (€œcells diffed) on cytospin, to a maximum of 100 cells per specimen, were obtained for each sample. Results A total of 577 CSF samples from 332 patients were submitted and analyzed for cell counts, of which 471 (82%) had NC count ≤10/mcl. There was a significant moderate positive correlation between NC count and cells diffed (Pearson correlation coefficient, 0.45, P-value &lt;0.001). Of these 471 samples, 24 (5%) showed evidence of peripheral blood contamination (&gt;500/mcl RBCs in samples with NC = 0/mcl, &gt;500 x (NC count)/mcl RBCs in samples with NC &gt; 0/mcl). A total of 4 cases from two patients with NC ≤10/mcl (0.8%) showed blasts on manual differential. Both patients had B-lymphoblastic leukemia/lymphoma and were being evaluated for CNS involvement with concurrent cytology. One patient was diagnosed as negative for CNS involvement by cytology. The sample for manual differential was contaminated by peripheral blood, hence the presence of blasts did not represent CNS disease. The second patient had the remaining 3 positive samples and was diagnosed with CNS involvement by cytology on multiple follow-ups. Conclusion Performing CSF manual differential when NC &lt; 10/mcl does not provide additional clinically actionable information and is associated with a lower cell yield on the cytospin. Establishing a NC count cutoff for performing manual differential will prevent unnecessary testing, decrease turnaround time, and increase precision. Exceptions may be necessary for oncology patients at high risk for CNS involvement.

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