scholarly journals A study of cellular counting to determine minimum thresholds for adequacy for liquid-based cervical cytology using a survey and counting protocol

2015 ◽  
Vol 19 (22) ◽  
pp. 1-64 ◽  
Author(s):  
Henry C Kitchener ◽  
Matthew Gittins ◽  
Mina Desai ◽  
John HF Smith ◽  
Gary Cook ◽  
...  
Keyword(s):  
Cell Count ◽  
Practice Guidelines ◽  
Cervical Screening ◽  
Cell Counting ◽  
Counting Method ◽  
Laboratory Practice ◽  
Normal Cells ◽  
Cell Counts ◽  
Cytological Abnormalities ◽  
The Impact

BackgroundLiquid-based cytology (LBC) for cervical screening would benefit from laboratory practice guidelines that define specimen adequacy for reporting of slides. The evidence base required to define cell adequacy should incorporate both ThinPrep™ (TP; Hologic, Inc., Bedford, MA, USA) and SurePath™ (SP; BD Diagnostics, Burlington, NC, USA), the two LBC systems used in the UK cervical screening programmes.ObjectivesThe objectives of this study were to determine (1) current practice for reporting LBC in England, Wales and Scotland, (2) a reproducible method for cell counting, (3) the cellularity of slides classified as inadequate, negative or abnormal and (4) the impact of varying cellularity on the likelihood of detecting cytological abnormalities.DesignThe study involved four separate arms to pursue each of the four objectives. (1) A questionnaire survey of laboratories was conducted. (2) A standard counting protocol was developed and used by three experienced cytopathologists to determine a reliable and reproducible cell counting method. (3) Slide sets which included a range of cytological abnormalities were each sent to three laboratories for cell counting to study the correlation between cell counts and reported cytological outcomes. (4) Dilution of LBC samples by fluid only (unmixed) or by dilution with a sample containing normal cells (mixed) was performed to study the impact on reporting of reducing either the total cell count or the relative proportion of abnormal to normal cells.SettingThe study was conducted within the cervical screening programmes in England, Wales and Scotland, using routinely obtained cervical screening samples, and in 56 participating NHS cervical cytology laboratories.ParticipantsThe study involved only routinely obtained cervical screening samples.InterventionsThere was no clinical intervention.Main outcome measuresThe main outcome measures were (1) reliability of counting method, (2) correlation of reported cytology grades with cellularity and (3) levels of detection of abnormal cells in progressively diluted cervical samples.ResultsLaboratory practice varied in terms of threshold of cellular adequacy and of morphological markers of adequacy. While SP laboratories generally used a minimum acceptable cell count (MACC) of 15,000, the MACC employed by TP laboratories varied between 5000 and 15,000. The cell counting study showed that a standard protocol achieved moderate to strong inter-rater reproducibility. Analysis of slide reporting from laboratories revealed that a large proportion of the samples reported as inadequate had cell counts above a threshold of 15,000 for SP, and 5000 and 10,000 for TP. Inter-rater unanimity was greater among more cellular preparations. Dilution studies demonstrated greater detection of abnormalities in slides with counts above the MACC and among slides with more than 25 dyskaryotic cells.ConclusionsVariation in laboratory practice demonstrates a requirement for evidence-based standards for designating a MACC. This study has indicated that a MACC of 15,000 and 5000 for SP and TP, respectively, achieves a balance in terms of maintaining sensitivity and low inadequacy rates.Future workThe findings of this study should inform the development of laboratory practice guidelines.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals The Graphical Representation of Cell Count Representation; a New Procedure for the Diagnosis of Periprosthetic Joint Infections

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 346
Author(s):  
Bernd Fink ◽  
Marius Hoyka ◽  
Elke Weissbarth ◽  
Philipp Schuster ◽  
Irina Berger
Keyword(s):  
Cell Count ◽  
Graphical Representation ◽  
Diagnostic Value ◽  
Cell Counting ◽  
Wear Particles ◽  
Type Iv ◽  
Joint Infections ◽  
Cell Counts ◽  
Matrix Assessment ◽  
Wbc Count

Aim: This study was designed to answer the question whether a graphical representation increase the diagnostic value of automated leucocyte counting of the synovial fluid in the diagnosis of periprosthetic joint infections (PJI). Material and methods: Synovial aspirates from 322 patients (162 women, 160 men) with revisions of 192 total knee and 130 hip arthroplasties were analysed with microbiological cultivation, determination of cell counts and assay of the biomarker alpha-defensin (170 cases). In addition, microbiological and histological analysis of the periprosthetic tissue obtained during the revision surgery was carried out using the ICM classification and the histological classification of Morawietz and Krenn. The synovial aspirates were additionally analysed to produce dot plot representations (LMNE matrices) of the cells and particles in the aspirates using the hematology analyser ABX Pentra XL 80. Results: 112 patients (34.8%) had an infection according to the ICM criteria. When analysing the graphical LMNE matrices from synovia cell counting, four types could be differentiated: the type “wear particles” (I) in 28.3%, the type “infection” (II) in 24.8%, the “combined” type (III) in 15.5% and “indeterminate” type (IV) in 31.4%. There was a significant correlation between the graphical LMNE-types and the histological types of Morawietz and Krenn (p < 0.001 and Cramer test V value of 0.529). The addition of the LMNE-Matrix assessment increased the diagnostic value of the cell count and the cut-off value of the WBC count could be set lower by adding the LMNE-Matrix to the diagnostic procedure. Conclusion: The graphical representation of the cell count analysis of synovial aspirates is a new and helpful method for differentiating between real periprosthetic infections with an increased leukocyte count and false positive data resulting from wear particles. This new approach helps to increase the diagnostic value of cell count analysis in the diagnosis of PJI.

scholarly journals Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Jose Orsini ◽  
Noeen Ahmad ◽  
Ashvin Butala ◽  
Rosemarie Flores ◽  
Truc Tran ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Hiv Infection ◽  
Cell Count ◽  
Hiv Viral Load ◽  
Viral Loads ◽  
Cell Counts ◽  
Time Of Admission ◽  
The Impact

Background. Although access to HAART has prolonged survival and improved quality of life, HIV-infected patients with severe immunosuppression or comorbidities may develop complications that require critical care support. Our objective is to evaluate the etiology of respiratory failure in patients with HIV infection admitted to the ICU, its relationship with the T-lymphocytes cell count as well as the use of HAART, and its impact on outcome.Methods. A single-center, prospective, and observational study among all patients with HIV-infection and respiratory failure admitted to the ICU from December 1, 2011, to February 28, 2013, was conducted.Results. A total of 42 patients were admitted during the study period. Their median CD4cell count was 123 cells/μL (mean 205.7, range 2.0–694.0), with a median HIV viral load of 203.5 copies/mL (mean 58,676, range <20–367,649). At the time of admission, 23 patients (54.8%) were receiving HAART. Use of antiretroviral therapy at ICU admission was not associated with survival, but it was associated with higher CD4cell counts and lower HIV viral loads. Twenty-five patients (59.5%) had respiratory failure secondary to non-HIV-related diseases. Mechanical ventilation was required in 36 patients (85.1%). Thirteen patients (31.0%) died.Conclusions. Noninfectious etiologies of respiratory failure account for majority of HIV-infected patients admitted to ICU. Increased mortality was observed among patients with sepsis as etiology of respiratory failure (HIV related and non-AIDS related), in those receiving mechanical ventilation, and in patients with decreased CD4cell count. Survival was not associated with the use of HAART. Complementary studies are warranted to address the impact of HAART on outcomes of HIV-infected patients with respiratory failure admitted to ICU.

scholarly journals Factors Associated with Immune Discordant Responses in Treated HIV-infected Omani Patients

2019 ◽  
Vol 13 (1) ◽  
pp. 25-30
Author(s):  
Zied Gaifer Ali ◽  
Mohamed-Rachid Boulassel
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Opportunistic Infections ◽  
Significant Proportion ◽  
Hiv Viral Load ◽  
Viral Control ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Cell Counts ◽  
The Impact

Background: Despite sustained viral control by antiretroviral therapy (ART), some HIV-infected patients do not recover normal CD4+ T cell counts. This Discordant Immune Response (DIR) increases the risk of opportunistic infections. Objective: To evaluate the factors associated with DIR in HIV-infected Omani patients attending public sector clinics. Methods: All HIV-infected patients receiving ART with regular follow-up visits were eligible for this study. The DIR group comprised patients on ART for at least two years with plasma HIV viral load < 50 copies/mL and helper CD4+ T cell counts below 350 cells/μl. The Concordant Immune Responses (CIR) group was similar to DIR but with CD4+ T cell counts above 350 cells/μl. Univariate and multivariate analyses using logistic regression models were used to assess the impact of demographic characteristics, clinical, immunological and virological parameters, type of ART regimens, tuberculosis and other opportunistic co-infections on DIR. Results: Among 153 enrolled participants, 28 and 76 patients were identified as having DIR and CIR, respectively. The multivariate analysis revealed that the only factors independently associated with DIR after adjustment were age (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.04-1.23), baseline CD4+ T cell count (OR: 0.98; CI: 0.97-0.99) and baseline CD56+ cell count (OR: 0.97; CI: 0.96-0.99). Conclusion: Collectively, these findings suggest that a significant proportion of HIV-infected Omani patients develop DIR totaling 27%, and efforts should be made to improve early identification of these patients who tend to experience poor clinical outcomes.

Preparation and Use of Somatic Cell Count Samples (SCCS) for Comparison of Milk Somatic Cell Counting Methods

1987 ◽  
Vol 50 (2) ◽  
pp. 132-135 ◽  
Author(s):  
T. J. LINTNER ◽  
A. L. LANGE ◽  
C. W. HEALD ◽  
R. J. EBERHART
Keyword(s):  
Somatic Cell ◽  
Cell Count ◽  
Somatic Cell Count ◽  
Bovine Milk ◽  
Coulter Counter ◽  
Cell Counting ◽  
Cell Content ◽  
Cell Counts ◽  
Counting Methods ◽  
Before And After

Somatic cell count samples (SCCS) for use in comparison of milk somatic cell counting methods were prepared from the cell sediment deposited in a creamery milk separator. Bovine milk somatic cells were resuspended from the sediment, and serial cell dilutions were prepared in bronopol-preserved milk diluent. Over a 1-year period, sets of SCCS were prepared each month and sent to milk-testing laboratories in the U.S.A., Canada and Europe, and counted by the methods in use at those Laboratories: (a) direct microscopic somatic cell count (DMSCC), (b) Fossomatic counter and (c) Coulter counter. Cell counts were normalized to eliminate the effect of month to month variation in the cell content of the SCCS. Counts obtained by the three methods were similar, although Coulter counter results tended to be lower, and significantly lower (P&lt; 0.05) in SCCS with cell counts greater than 700,000 cells/ml than those counts by the other two methods. The effect of shipping on SCCS stability was assessed for SCCS samples sent to and returned from other laboratories, and counted by the Fossomatic method on their return. Counts were similar before and after shipping, except that results for SCCS with cell counts greater than 1,000,000 cells/ml were significantly higher (P&lt;0.05) after their return.

scholarly journals Combined blood cell counting and classification with fluorochrome stains and flow instrumentation.

1976 ◽  
Vol 24 (1) ◽  
pp. 396-401 ◽  
Author(s):  
H M Shapiro ◽  
E R Schildkraut ◽  
R Curbelo ◽  
C W Laird ◽  
B Turner ◽  
...  
Keyword(s):  
Blood Cell ◽  
Cell Counting ◽  
Disulfonic Acid ◽  
Counting Method ◽  
Cell Counts ◽  
Human Blood Cells ◽  
Manual Counting ◽  
Blood Smears ◽  
White Blood Cell Counts ◽  
Blood Cell Counting

A multiparameter flow cytophotometer was used to count and classify fixed human blood cells fluorochromed with a mixture of ethidium bromide (EB), brilliant sulfaflavine and a blue fluorescent stilbene disulfonic acid derivative (LN). The system measures light scattered by the cells and absorption at 420 nm for all cells. In addition, nuclear EB fluorescence (540 leads to 610 nm) and cytoplasmic fluorescence from LN (366 leads to 470 nm), brilliant sulfaflavine (420 leads to 520 nm) and EB exicted by energy transfer from LN (366 leads to 610 nm) are measured for all nucleated cells. This information is sufficient to perform red and white blood cell counts and to classify leukocytes as lymphocytes, monocytes, basophils, eosinophils or neutrophils. Light scattering and/or nuclear and cytoplasmic fluorescence values may be further analyzed to obtain the ratio of immature to mature neutrophils. Counts produced by the system are in reasonable agreement with those obtained by electronic cells counting and examination of Wright's-stained blood smears; some discrepancies appear to be due to systematic errors in the manual counting method.

The impact of diabetes on CD4 recovery in persons with HIV in an urban clinic in the United States

2017 ◽  
Vol 29 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Julie A Zuniga ◽  
Kirk A Easley ◽  
Neeta Shenvi ◽  
Minh L Nguyen ◽  
Marcia Holstad
Keyword(s):  
African American ◽  
T Cell ◽  
Cell Count ◽  
African American Women ◽  
Cd4 T Cell ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell ◽  
The Impact ◽  
Cd4 T Cell Count

The purpose of this study was to exam the impact of type 2 diabetes mellitus (T2DM) on CD4 cell count trends in adults with HIV. In a longitudinal retrospective study in an urban primary care HIV clinic in the southeastern United States from 2010 to 2012, patients with HIV medical charts were audited to obtain their CD4 cell count, diabetes status, weight, and demographic information. Rates of increase of CD4 T cell count (i.e. slopes) were obtained using a linear mixed-effects model. Most of the HIV–T2DM cohort (n = 262) and HIV-only cohort (n = 2399) were African American (76%) and male (77%). The CD4 T cell counts were consistently higher in the HIV–T2DM cohort ( p < .0001). The mean rate of CD4 T cell count increase (mean ± SE) was 63 ± 9 cells/µl/year in HIV–T2DM African American women and 28 ± 7 cells/µl/year in HIV–T2DM African American men ( p = 0.003). In the multivariable slope analysis, the CD4 T cell count increase was significantly faster for HIV–T2DM African American women than for all other patients (mean difference = 30/cells/µl/year, 95% CI: 13–47; p < 0.001). Gender, race/ethnicity, and the diagnosis of diabetes influenced the recovery of CD4 cell counts.

Somatic Cell Reference Samples for Calibration of Milk Somatic Cell Counting Methods

1984 ◽  
Vol 47 (9) ◽  
pp. 694-696 ◽  
Author(s):  
T. J. LINTNER ◽  
C. W. HEALD ◽  
R. J. EBERHART
Keyword(s):  
Somatic Cell ◽  
Cell Count ◽  
Somatic Cell Count ◽  
Potassium Dichromate ◽  
Collaborative Study ◽  
Skim Milk ◽  
Cell Counting ◽  
Cell Counts ◽  
Counting Methods ◽  
Raw Bulk Milk

Somatic cell count samples (SCCS) for use in calibration of milk somatic cell counting methods were prepared from raw bulk milk preserved with potassium dichromate. Somatic cells were separated by centrifugation, then appropriate cell dilutions were prepared in the dichromate-preserved skim milk. Somatic cell counts from SCCS stored at 4°C were stable over a 23-wk period. No bacterial contamination was detected in these samples. In a collaborative study among eight laboratories, SCCS were not affected by usual conditions by shipping. The SCCS can be used as reference standards for the direct microscopic somatic cell count and the Fossomatic and Coulter Counter somatic cell counting methods.

scholarly journals Approach to Classification of Cavitary Effusion and Comparison between Manual and Automatic Methods for Total Nucleated Cell Count

2018 ◽  
Vol 46 (1) ◽  
pp. 8
Author(s):  
Nilson Júnior da Silva Nunes ◽  
Naila Cristina Blatt Duda ◽  
Juliana Pereira Matheus ◽  
Ana Paula Soares Borenstein ◽  
Bruno Albuquerque de Almeida ◽  
...  
Keyword(s):  
Cell Count ◽  
Protein Concentration ◽  
Abdominal Cavity ◽  
Final Diagnosis ◽  
Cell Counting ◽  
Spearman Correlation ◽  
Excellent Correlation ◽  
Cell Counts ◽  
Traditional Classification

Background: Two classifications are used to categorize cavitary effusions using total nucleated cell count (TNCC): protein concentration and pathophysiology of its formation. The aims of the present study were to evaluate the correlation between the TNCC values of cavitary effusions obtained in the automatic and the manual method, and also evaluating the classification methodology. Materials, Methods & Results: Cavitary effusions were analyzed for physical, chemical and cytological aspects, as well as manual and automatic cell counts for the correlation between the traditional methods and those suggested by Stockham & Scott. Bland-Altman regression and Spearman correlation analysis were performed. Of the total, 44 were abdominal effusions (73.3%), 15 thoracic (25%) and 1 pericardial (1.7%). According to the traditional classification, most of the effusions were classified as modified transudates (40%) and according to the classification of Stockham and Scott, as transudates poor in protein (31.7%). The correlation between cell counting techniques between pure, modified and exudate transudates was 0.94, 0.97 and 0.94, respectively, indicating an excellent correlation between the parameters (p = 0.95%).Discussion: Considering the concentration of proteins and CCNT, the effusions classified as modified transudate were mainly caused by neoplastic processes (carcinomas/adenocarcinomas), since there are several mechanisms of their formation, such as large variation of protein concentration. According to the Stockham & Scott classification a unique classification is considered for exfoliative neoplastic effusions, the variation of the protein concentration of the effusion does not alter its classification. In neoplastic effusions, classified as exudates, lymphomas were the most prevalent, and hypercellularity (approximately 150,000 cells / μL) allowed this classification. When considering low-protein transudates, the findings related to low concentrations did not differ much from the traditional classification. In the ruptures of viscera and vessels, the hemorrhagic ones were the most frequent, thus, the cytological diagnosis is essential, since it can give information about the contamination with blood during the collection. Most of these were due to neoplasia as the underlying cause. A case of chylotorax was diagnosed by comparing cholesterol and triglyceride values of effusion and serum. In cases of uroperitoneum, the presence of urine in the abdominal cavity promotes the dilution of the fluid from the cavity, being initially classified as pure transudate and, with its permanence in the cavity, increasing the CCNT, becomes an exudate. As in cases of exfoliative neoplastic effusions, the classification of the uroperitoneum, according to Stockham & Scott, is classified directly into effusion due to rupture of the viscera, giving a quick and clear diagnosis. According to Stockham & Scott, cases classified as nonseptic exudates (n = 3), two of which resulted from feline infectious peritonitis (PIF). The effusive form of PIF presents with accumulations of fluid in the abdomen, having an inflammatory character, but according to the traditional classification, they enter the category of modified transudates, because, despite containing protein concentrations close to or above the serum level, they present a CCNT lower than an exudate. Cavitary effusions were classified as septic exudates when intracellular bacteria were present and in the present study, two effusions were classified as such in two patients, one with septic peritonitis and in the other the final diagnosis was not found. The high values of Spearman correlation coefficients found when comparing the automatic counts with the manual demonstrate that there is an excellent correlation between the methods and, the Bland-Altman test showed significant agreement between them.

Relationship of somatic cell count and cell volume analysis of goat's milk to intramammary infection with coagulase-negative staphylococci

1981 ◽  
Vol 48 (3) ◽  
pp. 393-403 ◽  
Author(s):  
Richard F. Sheldrake ◽  
Roderic J. T. Hoare ◽  
Victoria E. Woodhouse
Keyword(s):  
Somatic Cell ◽  
Cell Count ◽  
Cell Volume ◽  
Somatic Cell Count ◽  
Cell Counting ◽  
Coagulase Negative Staphylococci ◽  
Volume Analysis ◽  
Intramammary Infection ◽  
Cell Counts ◽  
The Mean

SummaryThe prevalence of intramammary infection in 4 commercial goat herds was studied in conjunction with electronic somatic cell count and volume analysis, determined using a Coulter Counter and volume analyser.Neither streptococci nor mycoplasma were isolated from any half and the prevalence of intramammary infection with Staphylococcus aureus ranged from 0 to 3% between herds. For coagulase-negative staphylococci the range for infected halves was 36–71%. There was no significant difference between the mean total microscopic somatic cell count for halves infected with coagulase-negative staphylococci and those free from infection. A similar trend was observed for electronic somatic cell counts although the mean electronic cell count was greater than the mean total microscopic count on the 2 occasions that they were compared. The correlation coefficients between the 2 cell counting methods were 0·86 and 0·94. Between herds there were significant differences in mean electronic somatic cell count, with herd means ranging from 438×103 to 1684×103 cells/ml. In 2 of the 4 herds studied, milk samples from halves infected with coagulase-negative staphylococci had a significantly higher prevalence of cell volume distributions with a modal cell volume between 65 µ3 and 100 µ3. This was attributed to a higher proportion of polymorphonuclear neutrophils.Use of electronic somatic cell count and cell volume analysis were considered of little value in predicting infection caused by coagulase-negative staphylococci as there was a high proportion of false negative and false positive predictions.

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