The advantage of PCR for MTB in comparison to ADA in diagnosing tubercular pleural effusion

Background: Tuberculosis continues to be an important health problem globally. The bacteriological confirmation of diagnosis in extrapulmonary tuberculosis patients is more difficult because most of the cases of extrapulmonary tuberculosis are paucibacillary in nature. In this study we have compared the pleural fluid ADA levels with PCR for MTB in pleural fluid to confirm the diagnosis of tuberculosis in the pleural fluid.Methods: The study was done over two years and a total of 106 patients with a clinico-radiological diagnosis of pleural effusion were enrolled for the study. The pleural fluid was aspirated and examined for total cell count, differential cell count, protein, sugar, ADA and PCR for MTB.A CT Thorax was done in all the 106 patients of pleural effusion and underlying consolidation along with pleural effusion was found in 60 patients.Results: The pleural fluid was exudative in nature in all the patients. 90 patients (84.9%) had lymphocyte predominant pleural effusion while 16 patients (15.1%) had neutrophil predominant pleural effusion. The overall sensitivity of ADA in all the cases of pleural effusion was 85.2% while the overall sensitivity of PCR for MTB in all the cases of pleural effusion was 51.1%. However, in the 60 patients of pleural effusion with underlying lung consolidation, the overall sensitivity of ADA was 69.1% while the overall sensitivity of PCR for MTB was 92.8% for diagnosing tubercular pleural effusion.Conclusions: PCR for MTB is a useful test along with ADA for diagnosing tubercular pleural effusion. PCR for MTB is especially useful in the diagnosis of tubercular pleural effusion in patients with underlying lung consolidation.

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DIFFERENTIAL CELL COUNT AS DIAGNOSTIC AND PROGNOSTIC MARKER OF ACUTE MYOCARDIAL INFARCTION

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v24i2.1320 ◽

2018 ◽

Vol 24 (2) ◽

pp. 175

Author(s):

Sri Anita ◽

Liong Boy Kurniawan ◽

Darwati Muhadi

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cell Count ◽

Inflammatory Marker ◽

St Elevation Myocardial Infarction ◽

Chi Square ◽

Cross Sectional ◽

Differential Cell Count ◽

Differential Cell ◽

St Elevation

Myocardial infarction is a necrosis of myocardial cells due to lack of blood and oxygen supply caused by obstruction of coronary arteries, mostly due to atherosclerosis processes. Increased inflammatory marker level is associated with poor cardiovascular prognosis. This study was aimed to know whether leukocytes count, differential cell count and the Ratio of Neutrophils-Lymphocytes (RNL) could distinguish between types of Acute Myocardial Infarction (AMI) and to evaluate its correlation with mortality. This was a cross-sectional retrospective study using medical records patients which were diagnosed as AMI by clinicians in Cardiac Centre of the Dr. Wahidin Sudirohusodo Hospital during the period of April 1st, 2015 - May 31st, 2016. Statistical analysis used the Mann-Whitney and Chi-Square test, p<0.05 was considered as significant. The total subjects were 435 patients divided into 289 ST- Elevation Myocardial Infarction (STEMI) and 146 Non-ST-Elevation Myocardial Infarction (NSTEMI). There were significant differences in that mean of leukocytes, neutrophils, lymphocytes, monocytes, eosinophils counts and RNL between STEMI and NSTEMI (p <0.05). Significant differences were also found in leukocyte, neutrophils, lymphocytes, eosinophils, basophils and RNL mean between those who died and survived (p <0.05) and a significant correlation between increased leukocytes, neutrophils, basophils counts with mortality (p <0.05). In conclusion, the number of leukocytes and leukocyte count can be used as diagnostic markers of AMI between STEMI and NSTEMI, as well as prognostic markers among patients who died and survived. Routine blood sampling cohort studies in patients with AMI can avoid the bias of the results obtained.

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Cell function in the bovine mammary gland: a preliminary study on interdependence of healthy and infected udder quarters

Journal of Dairy Research ◽

10.1017/s002202990600238x ◽

2007 ◽

Vol 74 (2) ◽

pp. 174-179 ◽

Cited By ~ 26

Author(s):

Roswitha Merle ◽

Anke Schröder ◽

Jörn Hamann

Keyword(s):

Cell Count ◽

Cell Function ◽

Cell Activity ◽

Polymorphonuclear Leucocytes ◽

Differential Cell Count ◽

Immune Reactions ◽

Cell Counts ◽

Differential Cell ◽

Group A ◽

Group B

Udder defence mechanisms are not completely explained by current mastitis research. The anatomical construction of the udder implies that infection of one udder quarter does not influence the immune status of neighbouring quarters. To test this hypothesis, we compared the immune reactions of individual udder quarters in response to microbial attacks. In the course of immune reactions, polymorphonuclear leucocytes (PMN) release oxygen radicals, which can be determined by chemiluminescence (CL). Milk from 140 udder quarters of 36 cows was analysed for somatic cell count (SCC), differential cell count, viability and CL activity. Quarters with an SCC <100000 cells/ml and free of pathogens were defined as uninfected, all other quarters were categorized as infected. Three groups of cows were classified cytologically: group A (healthy, 11 animals, SCC limit <100000 cells/ml); group B (moderate mastitis, 8 cows, SCC [ges ]100000 and <400000 cells/ml in at least one quarter); and group C (severe mastitis, 17 cows, SCC [ges ]400000 cells/ml in at least one quarter). Infected and uninfected quarters in groups B and C were analysed separately. Viability of PMN leucocytes was significantly (P=0·0012) lower in group A (72·6%) than in healthy quarters of group C (84·0%). Lowering the SCC limit of healthy quarters to <50000 cells/ml (group A: all quarters within the udder) revealed striking differences between samples of groups B and C: in addition to varying differential cell counts and viabilities, CL activity of group B<50 (2929 CL units/million PMN) was markedly lower than that of the other groups (5616 in group A<50 and 6445 CL units/million PMN in group C<50). These results allow the conclusion that the infection of one udder quarter influences the cell activity of neighbouring quarters. When the SCC threshold for healthy quarters was reduced to 50000 cells/ml, greater differences in cell activities were detected between healthy udders and healthy quarters of infected udders.

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Differential Cell Count and Lymphocyte Subsets of Bronchoalveolar Lavage in Patients with Severe Granulocytopenia

Haematology and Blood Transfusion / Hämatologie und Bluttransfusion - Acute Leukemias IV ◽

10.1007/978-3-642-78350-0_146 ◽

1994 ◽

pp. 787-791

Author(s):

M. von Eiff ◽

O. Schlingheider ◽

F. Schulze ◽

C. Oehme ◽

N. Roos ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Cell Count ◽

Lymphocyte Subsets ◽

Differential Cell Count ◽

Differential Cell

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Diagnostic value of cytologic investigation of cell count differential of pleural fluid

Russian Pulmonology ◽

10.18093/0869-0189-2007-0-3-66-71 ◽

2007 ◽

pp. 66-71

Author(s):

O. G. Grigoruk ◽

A. F. Lazarev ◽

L. M. Bazulina

Keyword(s):

Breast Cancer ◽

Pleural Effusion ◽

Cell Count ◽

Pleural Fluid ◽

Lung Carcinoma ◽

Small Cell Lung Carcinoma ◽

Mesothelial Cell ◽

Diagnostic Value ◽

Primary Tumors ◽

Cell Lung Carcinoma

The cell count differential of pleural fluid sample is of great importance for estimation of the nature of pleural effusion. In the present article, we compared the efficiencies of routine cytology method with light microscopy, cytological examination with centrifuge Cytospin-4 and immunocytochemical methods. We have studied cytological samples from 1597 patients, with pleural effusion. Effusions associated with malignancies were reported in 22.7 % of patients including carcinomatosis (74.6 %), primary tumors of pleura (21.5 %), effusions associated with non epithelial malignancies (3.9 %). Benign pleural effusions were reactive (63.6 %), tuberculotic (13.5 %), "cholesterol pleurisy" and chylothorax (0.2 %). Carcinomatous pleuritis was found in patients with lung carcinoma (55.4 %), breast cancer (21.8 %) and ovary cancer (12.2 %). Specific malignant features (direct and indirect) were noted in pleural fluid on breast cancer, carcinomas of ovary, stomach, kidney, small cell lung carcinoma and squamous cell lung carcinoma. These features are hardly detected in patients with malignancies of intestines, prostate and endometria because these types of tumours are rarely metastatic to pleura. We were failed to define particular features of lung adenocarcinoma. The centrifuge Cytospin-4 was used in the most difficult cases (13.5 %) providing minimal number of presumable diagnosis. Primary tumours of pleura are the most difficult for detection. Immunocytochemical analysis found monoclonal mesothelial cell of НВЕМ 1 clone, cytokeratin, vimentin to be positive and carcinoembry onic antigen, Ber-EP4, CD-15 to be negative in the studied tumors.

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Chylothorax with Transudate: An Unusual Presentation of Tuberculosis

European Journal of Case Reports in Internal Medicine ◽

10.12890/2020_001645 ◽

2020 ◽

Author(s):

Miguel Angel Zamora-López ◽

Iris Camelia Farias-Navarro ◽

Erick Joel Rendon-Ramirez

Keyword(s):

Mycobacterium Tuberculosis ◽

Pleural Effusion ◽

Pleural Fluid ◽

Lung Nodule ◽

Cholesterol Content ◽

Tuberculosis Patients ◽

Fluid Analysis ◽

Pleural Tuberculosis ◽

Uncommon Presentation ◽

Low Cholesterol

Introduction: Twenty-five per cent of tuberculosis patients have pleural tuberculosis, which is the third most common form of presentation. Most cases present as an exudative pleural effusion with just few cases reported as chylothorax in the literature. All pleural effusions from confirmed cases, including tuberculous chylothorax, had exudate features. Aim: To describe a patient with Mycobacterium tuberculosis affecting the lungs and pleura, which laboratory testing demonstrated had features of transudate chylothorax. Patient and methods: A 70-year-old man presented with constitutional symptoms, progressive exertional dyspnoea and right pleural effusion with fibrocavitary changes on chest imaging. Thoracentesis and pleural fluid analysis revealed chylous fluid with transudate features, high triglycerides, low cholesterol content and mononuclear cell predominance. Acid-fast sputum stains and pleural fluid were negative for Mycobacterium tuberculosis as was an adenosine deaminase test for pleural effusion. Tomography-directed lung biopsy sampling of a lung nodule revealed a chronic granulomatous inflammatory process associated with the presence of acid-fast bacilli. Discussion: Tuberculosis-associated chylothorax is an uncommon presentation of the disease. A recent review found only 37 cases of confirmed tuberculous chylothorax had been reported in the literature. All cases had exudate characteristics. The diagnosis of pleural tuberculosis was made through culture or testing of sputum, pleural fluid or biopsy samples in 72.2% of cases, with the rest identified by histopathology.

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Assessment of subclinical mastitis diagnostic accuracy by differential cell count in individual cow milk

Italian Journal of Animal Science ◽

10.1080/1828051x.2018.1533391 ◽

2018 ◽

Vol 18 (1) ◽

pp. 460-465 ◽

Cited By ~ 2

Author(s):

Alfonso Zecconi ◽

Diego Vairani ◽

Micaela Cipolla ◽

Nicoletta Rizzi ◽

Lucio Zanini

Keyword(s):

Diagnostic Accuracy ◽

Cell Count ◽

Subclinical Mastitis ◽

Cow Milk ◽

Differential Cell Count ◽

Differential Cell

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VARIATIONS OF SOMATIC CELLS AND NEUTROPHILS IN MILK THROUGHOUT LACTATION1

Journal of Milk and Food Technology ◽

10.4315/0022-2747-35.4.197 ◽

1972 ◽

Vol 35 (4) ◽

pp. 197-202 ◽

Cited By ~ 11

Author(s):

C. L. Duttschaever ◽

G. C. Ashton

Keyword(s):

Cell Count ◽

Milk Yield ◽

Neutrophil Count ◽

Somatic Cells ◽

Total Cell ◽

Holstein Cows ◽

Total Cell Count ◽

Cell Counts ◽

Neutrophil Percentage ◽

Differential Cell

Total and differential cell counts were obtained for alternate weekly morning and evening milk from 11 Holstein cows in six different lactations. Milk from quarters suspected of mastitis were examined for presence of pathogens. Weekly cell counts for each cow showed large variations throughout lactation. The neutrophil count closely paralleled the total cell count. The average neutrophil percentage varied from 65 to 96%. No relationship was observed between cell count or type and length of lactation, age of cow, and milk yield. In addition to mastitis, unspecified stresses seemed to cause irregular sudden increases in somatic cells. Except during severe stresses, total cell counts were about 200,000 per milliliter, of which 65 to 90% were neutrophils.

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