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 Serum C - Reactive Protein, White Cell Counts and Neutrophil Percentage are Predictors For Distal Ureteric Calculus Expulsion Rate: A Prospective Study

2019 ◽  
Vol 8 (1) ◽  
pp. 58-62
Author(s):  
Ram Sagar Shah ◽  
Kaushal Sigdel
Keyword(s):  
Cell Count ◽  
White Cell Count ◽  
White Cell ◽  
C Reactive Protein ◽  
Expulsion Rate ◽  
Reactive Protein ◽  
Ureteric Calculus ◽  
Cell Counts ◽  
Neutrophil Percentage ◽  
Wbc Count

Background: To determine the relationship between expulsion rate of distal ureteric calculus less than orequal to 10mm in size and C reactive protein (CRP) level, white cell count and neutrophil percentage. Materials and Methods: A total of 186 patients with distal ureteric calculus of ≤10mm were evaluated for stone expulsion rate and its correlation with serum CRP, white cell count and neutrophil percentage. All patients received tablet Tamsulosin 0.4mg for 4 weeks or till the expulsion of stone. Patients were called weekly till 4 weeks, or early if there was history of stone expulsion. Patients were divided in two groups according to normal and elevated CRP levels, white cell count and neutrophil percent age at baseline for statistical analysis. Results: The patients had an average age of 35.6 } 13.9 years. 52.2% were male. Ratio of right to left was1.58:1. Majority of the patients with distal ureteric calculus ≤ 10mm passed their stone (74.7 %) with medical expulsion therapy. Expulsion of stone less than 5mm was statistically significant (p0.017). Patients with normal neutrophil percentage and normal CRP level had higher stone expulsion rate than elevated neutrophil or CRP (85.2% vs. 40.9, 91.8% vs. 30.8% respectively).In patients with normal white cell count, 86.4% passed their stone while in elevated white cellcount group 39.1% passed their stone. Conclusion: This study showed patients with distal ureteric calculus of ≤10mmwith normal CRP level and normal neutrophil count had higher expulsion rate while WBC count showed no statistically significant association.

Limited diagnostic value of serum inflammatory biomarkers in the diagnosis of fracture-related infections

2020 ◽  
Vol 102-B (7) ◽  
pp. 904-911
Author(s):  
Irene K. Sigmund ◽  
Maria Dudareva ◽  
Daniel Watts ◽  
Mario Morgenstern ◽  
Nicholas A. Athanasou ◽  
...  
Keyword(s):  
Decision Tree ◽  
Cell Count ◽  
Diagnostic Value ◽  
Serum Markers ◽  
Consensus Definition ◽  
Preoperative Serum ◽  
Diagnostic Decision ◽  
Wbc Count ◽  
Sensitivity Specificity ◽  
Serum Crp

Aims The aim of this study was to evaluate the diagnostic value of preoperative serum CRP, white blood cell count (WBC), percentage of neutrophils (%N), and neutrophil to lymphocyte ratio (NLR) when using the fracture-related infection (FRI) consensus definition. Methods A cohort of 106 patients having surgery for suspected septic nonunion after failed fracture fixation were studied. Blood samples were collected preoperatively, and the concentration of serum CRP, WBC, and differential cell count were analyzed. The areas under the curve (AUCs) of diagnostic tests were compared using the z-test. Regression trees were constructed and internally cross-validated to derive a simple diagnostic decision tree. Results Using the FRI consensus definition, 46 patients (43%) were identified as infected. Sensitivity, specificity, and AUC of CRP were 67% (95% confidence interval (CI) 52% to 80%), 61% (95% CI 47% to 74%), and 0.64 (95% CI 0.54 to 0.74); of WBC count were 17% (95% CI 9% to 31%), 95% (95% CI 86% to 99%), and 0.57 (95% CI 0.50 to 0.62); of %N 13% (95% CI 6% to 26%), 87% (95% CI 76% to 93%), and 0.50 (95% CI 0.43 to 0.56); and of NLR 28% (95% CI 17% to 43%), 80% (95% CI 68% to 88%), and 0.54 (95% CI 0.46 to 0.63), respectively. A better performance of serum CRP was shown in comparison to the leucocyte count (p = 0.006), %N (p < 0.001), and NLR (p = 0.001). A statistically lower serum CRP level was shown in patients with an infection caused by a low virulence microorganism in comparison to high virulence bacteria (p = 0.008). We found that a simple decision tree approach using only low serum neutrophils (< 3.615 × 109/l) and low CRP (< 2.45 mg/l) may allow better identification of aseptic cases. Conclusion The evaluated serum inflammatory markers showed limited diagnostic value in the preoperative diagnosis of FRI when using the uniform FRI Consensus Definition. Therefore, they should remain as suggestive criteria in diagnosing FRI. Although CRP showed a higher performance in comparison to the other serum markers, it is insufficiently accurate to diagnose a septic nonunion, especially when caused by low virulence microorganisms. Cite this article: Bone Joint J 2020;102-B(7):904–911.

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.

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.

569. A comparison of the diagnostic value of the total and differential cell counts of bovine milk

1955 ◽  
Vol 22 (1) ◽  
pp. 37-42 ◽  
Author(s):  
P. S. Blackburn ◽  
Constance M. Laing ◽  
D. F. Malcolm
Keyword(s):  
Cell Count ◽  
Bovine Milk ◽  
Diagnostic Value ◽  
Total Cell ◽  
Total Cell Count ◽  
Bacteriological Examination ◽  
Stage Of Lactation ◽  
Cell Counts ◽  
Differential Cell

Total and differential cell counts were obtained for 1710 samples of milk taken from cows in which the stage of lactation was known. A bacteriological examination of the samples was also made. The total and differential cell counts considered together showed no marked advantage over the total cell count alone in the diagnosis of mastitis, except in milk of late lactation.

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.

Comparison of Semiautomated Method with Official Optical Somatic Cell Counting Method III for Determining Somatic Cells in Milk

1984 ◽  
Vol 67 (3) ◽  
pp. 615-617
Author(s):  
Richard D Mochrie ◽  
David A Dickey
Keyword(s):  
Somatic Cell ◽  
Cell Count ◽  
Geometric Mean ◽  
Cell Counting ◽  
Official Method ◽  
Halogen Lamp ◽  
Precision Error ◽  
Cell Counts ◽  
New Instrument ◽  
New Machine

Abstract The new method specifying the Fossomatic-90 differs from the official method, 46.105–46.109, in that the modified instrument includes a halogen lamp; a semiconductor photoelectric detector; a less expensive, bench-top cabinet; manual injection of a larger sample, and a reduced capacity. The new instrument was compared with 2 optical somatic cell counters in routine use. On each of 3 days, 12 subsamples were prepared for each of 5 cell count levels from AM milk with half kept fresh and half preserved with 0.05% potassium dichromate. Subsamples were refrigerated and read 30+ h post-collection. Duplicate sets were read in random order on each machine daily (CV 0.77%). Two sets of slides read by 2 technicians each (strip reticle on 2 smears/slide) gave geometric mean direct microscopic somatic cell count (DMSCC) levels of 296, 526, 772, 930, and 1438 th/mL. Within-technician CV values (from day-level means) ranged from 1.6S to 2.28%. Geometric mean cells in th/mL on the new machine were significantly higher than those on the other two (674 vs 621) and were closer to the DMSCC (694). On the new machine, cell counts were 8.5% greater than on the original machines, were only 2.9% lower than the DMSCC, and showed no significant evidence of bias. Preserved samples averaged slightly greater than fresh (5.3%) but only on the original machines. Carryover by covariance analysis was insignificant. Except for cell levels, high machine precision (error CV value of 1.18%) gave differences with statistical but not practical significance, even for regulatory laboratories.

Use of the DeLaval cell counter (DCC) on goats' milk

2007 ◽  
Vol 74 (3) ◽  
pp. 345-348 ◽  
Author(s):  
Elizabeth Berry ◽  
Jennifer Broughan
Keyword(s):  
Cell Count ◽  
Dairy Industry ◽  
Reference Method ◽  
Cell Counting ◽  
Methyl Green ◽  
Dairy Production ◽  
Cell Counts ◽  
Bulk Milk ◽  
Cell Counter ◽  
Significant Factors

Milk quality is measured by a variety of parameters and one of these is the number of somatic cells in the milk. Within the bovine dairy industry there are maximum acceptable levels on bulk milk cell counts and these are being introduced into caprine dairy production. The reference method for cell counting in goats is the direct microscope (DM) method using pyronin Y-methyl green stain, which stains cell DNA. The use of the DeLaval cell counter (DCC) on goats' milk was compared with this reference method. Samples from 102 udder halves were cell counted using the direct microscope method and the DeLaval cell counter (DCC). Each sample was counted twice by two different observers by the DM method and once using DCC. DCC showed large coefficients of regression (1·03) and correlation (0·95) when compared with the DM cell count (F1,199=1080·0; P<0·001). Goat, udder half and reader type were significant factors.

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