scholarly journals Pediatric Acute Promyelocytic Leukemia

2021 ◽  
Vol 8 (11) ◽  
Author(s):  
Campos Davó E ◽  
◽  
Verdú Belmar J ◽  
Garzó Moreno A ◽  
de Paz Andrés F ◽  
...  
Keyword(s):  
Blood Smear ◽  
Peripheral Blood Smear ◽  
International Normalized Ratio ◽  
Skin Lesions ◽  
Pediatric Emergency ◽  
Promyelocytic Leukemia ◽  
Pediatric Emergency Department ◽  
Laboratory Results ◽  
Wbc Count

A previously healthy 4-year-old boy presented to the pediatric emergency department with high fever, headache, asthenia and neutropenia. The fever started two days prior along with the appearance of purple skin lesions. Laboratory results were as follows: White Blood Cell (WBC) count of 44.2 × 109 hemoglobin 62g/L; hematocrit 18.9%, platelet count 30 × 109/l, international normalized ratio (INR) 1.06, lactate dehydrogenase (LDH) 479u/l, creatinine 37μmol/l. Peripheral blood smear demonstrated: 80% of abnormal promyelocytes with bilobar nuclei and cytoplasmic granules; some contained multiple Auer rods. Immunophenotyping demonstrates CD13, CD33, CD117, and myeloperoxidase positivity with a high side-scatter. Fluorescence in situ hybridization revealed the t(15;17) (q22;q21.1) (PML-RARA) (Figure 1 and 2).

In situ simulation in the management of anaphylaxis in a pediatric emergency department

2018 ◽  
Vol 14 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Simona Barni ◽  
Francesca Mori ◽  
Mattia Giovannini ◽  
Marco de Luca ◽  
Elio Novembre
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
In Situ Simulation

scholarly journals Pediatric Acute Promyelocytic Leukemia Presenting to the Emergency Department as Refusal to Ambulate

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Kevin R. Schwartz ◽  
Jennifer M. Hanson ◽  
Alison M. Friedmann
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Acute Promyelocytic Leukemia ◽  
Blood Smear ◽  
Brain Mri ◽  
Pediatric Intensive Care ◽  
Peripheral Blood Smear ◽  
Promyelocytic Leukemia ◽  
Severe Anemia ◽  
Intracranial Hemorrhages

A previously healthy 10-year-old girl presented to the emergency department (ED) with a headache and vomiting which resolved with oral NSAIDs. The patient returned two days later unable to ambulate with mental slowing and lower extremity bruising. Labs demonstrated marked leukocytosis, severe anemia and thrombocytopenia, and disseminated intravascular coagulation (DIC). Brain MRI showed multiple intracranial hemorrhages. A peripheral blood smear demonstrated blasts with many Auer rods. A diagnosis of acute promyelocytic leukemia (APL) was made and therapy including all-transretinoic acid (ATRA) was initiated. Neurologic status returned to baseline within 1 week in the pediatric intensive care unit.

Undifferentiated Abdominal Pain in Children Presenting to the Pediatric Emergency Department

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1212-1223
Author(s):  
Brendan R. Harris ◽  
Sri S. Chinta ◽  
Ryan Colvin ◽  
David Schnadower ◽  
Phillip I. Tarr ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Laboratory Tests ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Laboratory Results ◽  
Ed Visits

Although common, little is known about the characteristics and management of undifferentiated abdominal pain (UAP) in the pediatric emergency department (ED). This study was a 12-month retrospective study for “abdominal pain” ED visits. Patients without an identifiable diagnosis were categorized as “UAP,” while others with identified disease processes were categorized as “structural gastrointestinal diagnosis (SGID).” We included 2383 (72%) visits with 869 (36.5%) UAP visits and 1514 (63.5%) SGID visits. SGID patients had more laboratory tests (811 [53.6%] vs 422 [48.6%], P = .0186), and often had multiple tests performed (565 [69.7%] vs 264 [62.6%], P = .0116). Computed tomography and ultrasound scans were more common in SGID (computed tomography: 108 [7.1%] vs 27 [3.1%], P = .0004; ultrasound: 377 [24.9%] vs 172 [19.9%], P = .0044), and laboratory results (white blood cell count, hemoglobin, albumin, C-reactive protein) were abnormal at significantly higher rates. Analyses revealed the duration of pain as primary covariate in variance of pain etiology. Clinical features, such as duration of pain, may be augmented by laboratory tests to facilitate recognition of UAP in the ED.

scholarly journals Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department

2016 ◽  
Vol 8 (5) ◽  
pp. 754-758 ◽  
Author(s):  
Anita A. Thomas ◽  
Neil G. Uspal ◽  
Assaf P. Oron ◽  
Eileen J. Klein
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Survey Study ◽  
Just In Time ◽  
Pediatric Emergency Department ◽  
Procedural Skills ◽  
Convenience Sample ◽  
Paired Difference ◽  
The Impact

ABSTRACT Background  Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. Objective  We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Methods  Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Results  Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills (P < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use (P = .30, paired difference −0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use (P < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use (P < .05, paired difference −0.4 points). Conclusions  Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training.

scholarly journals Hematological and Morphological Changes in the Peripheral Blood Smear of Patients with COVID-19

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Sawer Sabri Ahmed ◽  
Dilveen Ahmed Mohammed ◽  
Ayad Ahmad Mohammed
Keyword(s):  
Peripheral Blood ◽  
Eosinophil Count ◽  
Blood Smear ◽  
Morphological Changes ◽  
Clinical Manifestations ◽  
Peripheral Blood Smear ◽  
Blood Parameters ◽  
Blood Film ◽  
Normal Platelet ◽  
Wbc Count

Background: The novel coronavirus is responsible for a widespread pandemic, causing multiple clinical manifestations. Peripheral blood films have shown changes in white blood cell (WBC) morphology and counts, as well as platelet abnormalities. Atypical and reactive lymphocytes may also be observed in the blood film, which suggests mild leukoerythroblastosis. Objectives: The present study aimed to evaluate the hematological and morphological changes in the peripheral blood smear of patients with COVID-19. Methods: This study was conducted on 175 patients diagnosed with COVID‐19 infection. Blood samples were collected from the patients and examined for the estimation of blood parameters, differential cell count, and presence of atypical lymphocytes. Results: The mean age of the patients was 53.73 years, and males constituted 52.6% of the patients. The majority had normal hemoglobin levels. WBC count was normal in 60.6% of the patients, while 74.3% had normal platelet count, and thrombocytopenia was detected in 23.4%. In addition, differential WBC count indicated that 56.6% of the patients had normal neutrophils, while lymphopenia was detected in 28 and 77.7% had a low eosinophil count. The peripheral blood smears showed atypical lymphocytes with deeply basophilic cytoplasm in 21.14% of the patients. Conclusions: Blood film examination may show multiple abnormal findings in patients with COVID-19 infection. Neutrophilia and lymphopenia with the presence of atypical lymphocytes are frequently observed as well. Low eosinophil count is also highly common. Although platelets showed changes, they were normal or reduced in most cases.

Can the leukocyte`s parameters in peripheral blood smear predict risk of in-hospital death of patients undergoing high-risk gastrointestinal surgery?

2018 ◽  
Vol 91 (1) ◽  
pp. 1-5
Author(s):  
Michał Pluta ◽  
Łukasz Krzych
Keyword(s):  
High Risk ◽  
Peripheral Blood ◽  
Blood Smear ◽  
Gastrointestinal Surgery ◽  
Peripheral Blood Smear ◽  
Full Blood Count ◽  
Hospital Death ◽  
Significant Difference ◽  
Precise Analysis ◽  
Wbc Count

Introduction. White blood cell (WBC) count constitutes a part of routine peripheral blood examination (FBC, full blood count). Precise analysis of leukocytes’ parameters in blood smear is usually performed only when leukopenia or leukocytosis is found. We aimed to assess the usefulness of leukocytes’ smear test in predicting in-hospital death of patients undergoing high-risk gastrointestinal (GI) surgery. Materials & Methods. We prospectively enrolled 101 subjects undergoing high-risk GI surgery from 01.01.2017 till 31.12.2017. Blood tests were performed preoperatively, with analysis focused on the assessment of total WBC count, as well as the count of neutrophils (NEUT), lymphocytes (LYM), monocytes (MONO), eosinophils (EOS) and basophils (BASO). Indices of NEUT/LYM (NLR) and MONO/LYM (MLR) were calculated. In-hospital mortality was considered the outcome. Results. Mortality reached 5%. There was no significant difference in WBC count between survivors and the deceased (p=0.2) and WBC failed to predict the outcome (AUC=0.69; p=0.3). MONO (p=0.009) and BASO (p=0.02) counts, as well as MLR (p=0.007) were significantly higher in patients who died. MONO count and MLR index predicted in-hospital death with good accuracy, respectively: AUC[MONO]=0.85 (p<0.001) and AUC[MLR]=0.86 (p<0.001). Other investigated parameters played no significant role in outcome prediction. Conclusion. Routine peripheral blood smear evaluation should be considered in all patients undergoing high-risk GI surgery, because the number of monocytes can be a valuable predictor of in-hospital death.

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