Combining. and New Diagnostic. to Help Clinicians Achieve. Patient Outcomes at. per Healthcare Encounter
|
|
- Meredith Curtis
- 6 years ago
- Views:
Transcription
1 Combining and New Diagnostic to Help Clinicians Achieve Patient Outcomes at per Healthcare Encounter
2 Holly McDaniel, MD
3 Holly McDaniel, MD AP/CP and Cytopathologist Clin Path Associates Laboratory Medical Director Banner Estrella Medical Center Phoenix, AZ
4 Largest non profit health care system in the country serving patients across 7 states. Ten Medical Centers in the Phoenix Area
5 LABORATORY Day 5 CASE #1 Peripheral Blood Smear submitted for Path Review Metamyelocytes present Criteria based on Hematology Analyzer with a 5 Part Diff WBC Diff Type 33 H MANU Segs% 67% H Bands% 3% Meta% 3% H Myelo% 0% Pro% 0%
6 CASE #1 New Hematology Analyzer has 6 Part Diff Automated differential identifies Metas, Myelos and Pros as Immature Granulocytes (IG) IG = 6-Part Diff! Day 1 Day 5 IG 1.1% H IG 3.3% H
7 CASE #1 34 year old woman with multiple medical problems, treated with steroids for autoimmune disease. Increasing WBC, but mature neutrophilia. I think its demargination secondary to the steroids. What do you think? Her IG was mildly elevated on admission and is increasing. I think she has an infection. There are no clinical features of infection. I think it is demargination. Infection. Infection. Demargination. Demargination.
8 CASE #1 Day 5 ID Consult obtained Infection. Present on admission. NOT a Hospital Acquired Infection. Sputum culture taken Placed on empiric antibiotics Day 7 WBC and IG decreasing Discharged Day 9 Sputum positive for H. influenza LABORATORY Day 1 Day 3 Day 5 WBC 13 H 19 H 33 H Diff Type AUTO AUTO AUTO Segs% 65% H 65% H 67% H IG% 1.1% H 2.3% H 3.3% H
9 CASE #1 CBC Day 5 WBC 33 H Diff Type MANU CBC Day 5 WBC 33 H Segs% 67% H Diff Type AUTO Bands% 3% Segs% 70% H Meta% 3% H IG% 3% H Myelo% 0% Pro% 0% Which Lab results would you prefer?
10 IG (Immature Granulocyte) RET-He (Reticulocyte Hemoglobin Equivalent) IPF (Immature Platelet Fraction)
11 Our Set Up XE 5000 Reflex IPF RET-He NRBCs Cellavision WAM Flag for smear review Release Results Autoverification
12 TESTS LAB What do they mean? PHYSICIAN What do they MEAN? IG RET-He IPF Metas, Myelos, Pros Hb in Retics Immature platelet fraction Left Shift Iron Deficiency BM response to low PLTs
13 TESTS IG RET-He IPF LAB What do they mean? Metas, Myelos, Pros Hb in Retics Immature platelet fraction Patient Care PHYSICIAN What do they MEAN? WHAT DO Left Shift Iron Deficiency BM response to low PLTs THEY MEAN? 1. With or without anemia (new ICD10 code for Iron Deficiency!) 2. IV Iron, with or without Epo Support diagnosis of infection on admission Identify MPD Follow treatment LOS and HAI Identify Iron Deficiency 1 Treatable anemia 2 Pre operative Dx & Tx Readmissions RBC Transfusions LOS and HAI Unnecessary BM Bx Predict PLTrecovery PLT Transfusions LOS and HAI
14 Situation Need physicians to utilize improve patient care to Background Assessment Recommendation
15 IG (Immature Granulocyte) Myeloblast Pro Myelo Meta Band Seg mature immature IG ANC Identifies and quantifies immature myeloid cells 32,000 cells More sensitive and more precise than manual diff definition of Left Shift Early screen for sepsis Better indicator for infection than WBC IG% >1% indicates a left shift IG% >3% may predict positive blood cultures
16 Automated Differential Basophil Eosinophil Neutrophil Monocyte Lymphocyte Previous Analyzer 5 Part Diff Current Analyzer 6 Part Diff Basophil Eosinophil IG Neutrophil Monocyte Lymphocyte
17 How does IG compare to Band Count? Band Count is poorly reproducible Criteria for Bands is subjective Three different definitions How pinched is the nucleus? Neutrophil Band IG is than the Band Neutrophil? Band?
18 RET-He (Reticulocyte Hemoglobin Equivalent) Nucleated RBC Immature Reticulocyte Reticulocyte Equivalent to Reticulocyte Hemoglobin Content (CHr) Measurement of iron available to cells Not affected by uremia or inflammation Diagnose iron deficiency and response to treatment RET He shows treatment effect in 3 days Pre op evaluation of orthopedic patients can decrease RBC transfusions Inexpensive losing money if not utilized! Red Blood Cell RET-He is the Cellular Iron Level
19 CASE #2 40 year old woman presents to the ED with an episode of syncope the previous night with loss of consciousness for 1 minute. PMH Menorrhagia. Iron deficiency anemia treated with blood transfusions, Physical Exam Vital Signs Normal
20 Microcytic anemia RET He < 29 pg = Iron deficiency in adults (KDOQI Guidelines) Iron Transferrin Trans % Sat Ferritin High Normal High Low
21 Diagnosis: Severe iron deficiency anemia secondary to menorrhagia RET He confirmatory Iron studies: Conflicting results IV iron given prior to lab draw Treatment: IV iron Check RET He in 3 days for response Add Epo if needed Treat the cause of menorrhagia X Don t transfuse if hemodynamically stable
22 IPF (Immature Platelet Fraction) Megakaryocyte Immature Platelets Platelets Decreased Thrombopoietin Thrombopoietin stimulates decreases megakaryocytes platelet and production increases platelet production Normal or increased platelet count Low decreases platelet count thrombopoietin stimulates production thrombopoietin production Plts + Plts + % Immature PLTs Total PLTS Evaluate mechanism causing thrombocytopenia IPF recovers ~3 days earlier than platelet count Determine need for platelet transfusion Predict platelet count recovery IPF Peripheral destruction or BM Recovery IPF BM production disorder
23 IPF and Platelet Count Briggs, Carol et al. Assessment of an immature platelet fraction (IPF) in peripheral thrombocytopenia. British Journal of Haematology, 126, 93 99; 2003.
24 Situation Need physicians to utilize improve patient care to Background One analyzer Multiple which can impact: Infection/sepsis IG Anemia RET-He Blood utilization RET-He & IPF Assessment Recommendation
25 Our Process What we did Right Pick the right instrument Educate Lab and Pathologists Successful implementation in AZ hospitals
26 Our Process Communication o Educate Physicians Articles Handouts Table toppers SBAR Laboratory Memo Interpretative messages in EMR Presentations at Department Meetings o Educate Pharmacy & Nursing o Educate Administration Gave my CMO a mug!
27 Our Process What we could have done Integrate into Care Pathways and Caresets
28 Reticulocytes Dropped from Careset **Discontinued** Iron/Epoetin Careset **New current** Iron/Epoetin Discern Advisor RET-He part of Reticulocyte Comprehensive Order
29 Our Process What we could have done Integrate into Care Pathways and Caresets Sepsis Alert Fever 101 F or hypothermia (<96.8 F) Heart rate >90 beats/minute Respiration rate >20 breaths/minute White blood count >12,000 µl or <4,000 μlor with >10% bands
30 Situation Need physicians to utilize improve patient care to Background Assessment One analyzer Multiple which can impact: Infection/sepsis IG Anemia RET-He Blood utilization RET-He & IPF Under utilized Not available in Care Sets Recommendation
31 Our Process What we could have done Get a Seat at the Table Functional Teams Clinical Consensus Groups Strategic Clinical Initiative Teams Clinical Performance Groups Discipline Teams
32 Our Process What we could have done Reflex Testing for RET He Started with Hgb < 9.0 AND MCV <78 AND No previous in 30 days Need to adjust! X X X Don t need low Hb Don t need microcytic RBCs Can change in 3 days with treatment Recommend RET He Patients at risk for iron deficiency: Children, Women, Elderly Fractures Elective surgery pre op evaluation Inpatients receiving iron +/ Epo (Test every 3 days)
33 Our Process What we could have done Reflex Testing for IPF Thrombocytopenia: When to reflex to IPF? Started with PLT < 30,000 Moved to PLT < 50,000 Now at PLT < 100,000 Seeing cases where IPF impacts management BM biopsies not required Decreased PLT transfusion
34 CASE #3 40 year old woman presented with abdominal pain Recent diagnosis of Breast Carcinoma Treated with chemotherapy ~ 2 weeks ago Admission findings Ovarian mass Thrombocytopenia PLT 30 L IPF 15.0 H
35 35 Plts + IPF Peripheral destruction or BM Recovery Platelet Count Immature Platelet Fraction (IPF) Clinical impression No active bleeding Stable vital signs Surgery consult not an acute abdomen Day 1 IPF cut off 7.1 Options 1. Transfuse platelets to raise PLT > 50 and perform surgery to remove ovarian mass. 2. Wait to see if platelet count recovers, then perform surgery.
36 Platelet Count Immature Platelet Fraction (IPF) Follow up: Platelet count recovered. Surgery found a benign serous cystadenoma with torsion. No metastatic carcinoma. 20 IPF cut off Day 1 Day 2 Day 3 Day 4
37 IG RET-He IPF Support diagnosis of infection on admission Identify MPD Follow treatment Identify Iron Deficiency Treatable anemia Pre operative Dx & Tx Won t lose reimbursement for misdiagnosis of HAI LOS and HAI ICD10 for Iron Def Readmissions RBC Transfusions LOS and HAI Unnecessary BM Bx Predict PLTrecovery PLT Transfusions Cost for PLTs LOS and HAI
38 Situation Need physicians to utilize improve patient care to Background Assessment Recommendation One analyzer Multiple which can impact: Infection/sepsis IG Anemia RET-He Blood utilization RET-He & IPF Under utilized Not available in Care Sets Continue to educate Incorporate tests into Care Sets Fine tune reflex testing Obtain outcomes data Proactively assert Laboratory and Pathologist s expertise to help the Hospital meet its goals
39 Hospital Lab Nursing Physicians Pathologists Technologists Administration Informatics Pharmacy Finance Quality Pathologists
40 Need to align criteria for Manual Diff and Path Review with Analyzer s Ability to perform a 6 Part Diff WHERE TO START? New Criteria for Determining Differential Type and Requirement for Path Review using New Hematology Analyzer (Sysmex XE 5000) which Reports a 6 Part Differential
41 Is a PBS indicated? XE 5000 PILOT Study YES Manual Diff Is a Manual Diff required? Determined by Analyzer & Middle Ware No changes for Pilot Study NO Autoverified YES PBS Review Is a Path Review required? NO YES NO Auto Diff 6 Part Diff No Path Review
42 Is a Manual Diff required? 944 PBS performed Previous Analyzer (5 Part Diff) New Analyzer (6 Part Diff) % Auto Diffs 51% 87% % Manual Diffs 49% 13% Leveraging the 6 Part Differential Automated Diffs increased 36%
43 Reason for Manual Diff on Previous Analyzer (5 Part Diff) 294 of the 944 (31%) cases with Manual Diff using 5 Part Diff Criteria due to the presence of Immature Granulocytes (Metas, Myelos and/or Pros)
44 Is a Path Review required? Previous Analyzer (5 Part Diff) New Analyzer (6 Part Diff) # Path Reviews %Path Reviews 29% 5% 30% 25% 20% 15% 10% 5% Percent of PBS Requiring Path Reviews Leveraging the 6 Part Differential Path Reviews decreased 24% 0% Previous Analyzer (5 Part Diff) New Analyzer (6 Part Diff)
45 Reasons for Path Review following Previous Analyzer (5 Part Diff) Procedures Majority of PBS sent for Path Review due to presence of Immature Granulocytes (Metas, Myelos and/or Pros) Most in low numbers (E.G. 3 Metas)
46 Reasons for Path Review following New Analyzer (6 Part Diff) Procedures Fewer PBS sent for Path Review due to presence of Immature Granulocytes (Metas, Myelos and/or Pros) when higher threshold used. Higher thresholds possible because IG identified by Auto Diff.
47 Pilot Study Summary Side by side comparison of criteria used on Previous Analyzer (5 Part Diff) to updated criteria for New Analyzer (6 Part Diff) Scan of PBS slide confirms presence of Automated Diff Leveraging the 6 Part Diff Increased Automated Diffs by 36% Better CBC Reports with clear trending of IGs Decreased Pathology Reviews by 24% Fewer non value added Pathology Reviews More time to spend on PBS with significant findings
of s and s Disclosure
The s of s and s Successfully implement the Advanced Clinical Parameters to benefit the patient, the lab and the Accountable Care Organization Model Disclosure Honorarium from Sysmex for this lecture 1
More informationLEANING Away Waste and Improving Patient Care with Advances in Hematology
LEANING Away Waste and Improving Patient Care with Advances in Hematology Selke Mantie, MLS (ASCP), CLS (CSMLS), SSGBC Disclosure I am receiving an honorarium from Sysmex for today s presentation Objectives
More informationIt s Easier Than you Think How to Implement the Advanced Clinical Parameters
It s Easier Than you Think How to Implement the Advanced Clinical Parameters Implementation of our New Hematology Platform ( 9 HST Lines - 9 Facilities - 9 Month) Outline The Organization Banner Health
More information8/28/2015. ACP Toolbox SYSMEX CLINICAL SUPPORT TEAM SYSMEX CUSTOMER RESOURCE CENTER. Maggie Fischer BSN, RN, MS Carolyn Williams, BSN, RN, CRNI
ACP Toolbox Maggie Fischer BSN, RN, MS Carolyn Williams, BSN, RN, CRNI SYSMEX CLINICAL SUPPORT TEAM Available to provide education and resources: Tailored presentations Customer Resource Center tools Current
More information5/1/2017 DISCUSSION POINTS. Clinical Utility of Immature Cell Indices Beyond the Routine CBC John E. Donnelly BSN, RN
DISCUSSION POINTS Importance of hematological immature cell indices Clinical Utility of Immature Cell Indices Beyond the Routine CBC John E. Donnelly BSN, RN Investigate the evidence for clinical utility:
More informationEvidence-Based Hematological Solutions
Evidence-Based Hematological Solutions Beyond the Routine CBC Objectives Describe novel hematology parameters and their derivation. Investigate the evidence for their clinical utility. Discuss how new
More informationFull Blood Count analysis Is a 3 part-diff good enough? Dr Marion Münster, Sysmex South Africa
Full Blood Count analysis Is a 3 part-diff good enough? Dr Marion Münster, Sysmex South Africa The Role of the FBC in clinical decision making History Examination Investigations Decision 70% FBC Laboratory
More informationInterpreting Hematology Scatter-Plots; One Cancer Center s Keys to Seeing the BIG Picture
Interpreting Hematology Scatter-Plots; One Cancer Center s Keys to Seeing the BIG Picture Barbara L. Burch, MHA MT (ASCP) Laboratory Manager New York University Clinical Cancer Center Disclosure Ms Burch
More informationA Look Into the Determination of Cell Morphology in Hematology in the 21 st Century. Ramon Simon-Lopez, MD Global Scientific Director Beckman Coulter
A Look Into the Determination of Cell Morphology in Hematology in the 21 st Century Ramon Simon-Lopez, MD Global Scientific Director Beckman Coulter Is cell morphology important? AML M7 CLL CD5 CD19 NHL
More informationXN series. Case interpretation. Gebruikersdag Vlaanderen- 6 oktober 2016
XN series Case interpretation Gebruikersdag Vlaanderen- 6 oktober 2016 Fluorescence flow cytometry RET channel PLT-F channel WDF channel WPC channel WNR channel Case 1 Case 1: Initial measurement Patient
More informationHematology 101. Cindy Rogers, MT(ASCP) Diagnostics System Specialist
Hematology 101 Cindy Rogers, MT(ASCP) Diagnostics System Specialist More Acronyms...» CBC» RBC» HGB» HCT» WBC» MPV» PLT» RDW» DIFF» H&H» Complete Blood Count» Red Blood Cell» Hemoglobin» Hematocrit» White
More informationPlease contact Customer Service with any questions. Ph: option 5
Sarasota Memorial Laboratory Services is pleased to announce that we are now performing the following testing in house: Immature Platelet Fraction (IPF) The Immature Platelet Fraction (IPF) is used to
More informationMay is Better Sleep Month
Produced by Eastern Iowa Sleep Center A Partnership: UnityPoint-St.Luke s Mercy Medical Center Physicians Clinic of Iowa MAY 2015 VOLUME 4 ISSUE 2 Eastern Iowa Sleep Center May is Better Sleep Month Mother
More informationLavender Top Management SUCCESS BEYOND FINANCES
Lavender Top Management Alfonso Ziccardi Ass.Lab.Operation Manager for AP/CP/Safety Officer New York Hospital Medical Center of Queens SUCCESS BEYOND FINANCES 1 . VISION Mission/ Vision To successfully
More informationXN-SERIES. XN Technology and Case Studies
XN Technology and Case Studies Karen Hoffman MT(ASCP) Clinical Applications Specialist OBJECTIVES Explain how scattergrams and histogram pictures can provide great insight into abnormal hematology samples
More informationBlutbild 2012: Automatisiert oder manuell? Georg Stüssi Servizio di Ematologia Istituto Oncologico della Svizzera Italiana
Blutbild 2012: Automatisiert oder manuell? Georg Stüssi Servizio di Ematologia Istituto Oncologico della Svizzera Italiana IS THERE STILL A ROLE FOR THE MANUAL BLOOD COUNT? Indication for examination
More information10/15/2015. Clinical Utility of Immature Cell Indices DISCUSSION POINTS HEALTHCARE REFORM PAYMENT MODEL EXPERIMENTS
Clinical Utility of Immature Cell Indices Leveraging Technology to Help Manage Anemia and Blood Utilization donnellyj@sysmex.com 2015 Sysmex America, Inc. All rights reserved. For Clinical Support Team
More informationLavender Top Management SUCCESS BEYOND FINANCES. Mission/ Vision
Lavender Top Management Alfonso Ziccardi Lab.Operation Manager for AP/CP/Safety Officer New York Hospital Medical Center of Queens SUCCESS BEYOND FINANCES Mission/ Vision. VISION To successfully develop
More informationINFECTION/ INFLAMMATION
HAEMATOLOGY OCTOBER 2017* WHITE PAPER INFECTION/ INFLAMMATION Novel haematological parameters for rapidly monitoring the immune system response Patients with inflammatory disease are common on hospital
More informationDifferential Blood Smear H3
Verein für Association pour le Associazione per il medizinische Qualitätskontrolle contrôle de qualité médical controllo di qualità medico Report Differential Blood Smear H3 MQ 2015-4 MQ, Institut für
More information3/31/2017 OBJECTIVES CASE STUDY #1 MANUAL REVIEW. Hematology Case Studies: Every Picture Tells a Story
OBJECTIVES Hematology Case Studies: Every Picture Tells a Story Jason Anderson, MPH, MT(ASCP) Field Product Specialist Discuss how scattergram and histogram pictures can provide insight into abnormal hematology
More informationNotes for the 2 nd histology lab
Notes for the 2 nd histology lab Note : Please refer to the slides and see the morphological characteristics of each cell, as the practical exam will be in the form of figures. SLIDE #2 Erythropoiesis
More informationHematology 101. Blanche P Alter, MD, MPH, FAAP Clinical Genetics Branch Division of Cancer Epidemiology and Genetics Bethesda, MD
Hematology 101 Blanche P Alter, MD, MPH, FAAP Clinical Genetics Branch Division of Cancer Epidemiology and Genetics Bethesda, MD Hematocrits Plasma White cells Red cells Normal, Hemorrhage, IDA, Leukemia,
More informationUtilizing Sysmex RET He to Evaluate Anemia in Cancer Patients
Utilizing Sysmex RET He to Evaluate Anemia in Cancer Patients Ellinor I. Peerschke, Ph.D., F.A.H.A. Vice Chair, Laboratory Medicine Chief, Hematology & Coagulation Laboratory Services Memorial Sloan Kettering
More informationTaking The Fear Out of Abnormal CBC s Problems of Production, Destruction or loss
Taking The Fear Out of Abnormal CBC s Problems of Production, Destruction or loss Joanne Eddington, MN, FNP, AOCN Providence Oncology and Hematology Care Clinic - Eastside Blood Cell Abnormalities Abnormalities
More informationChanges to CBC Reference Ranges
September 28, 2016 July, 2017 Changes to CBC Reference Ranges At Dynacare, our vision is to be Canada s health and wellness solutions leader. As part of our commitment and continuous efforts to enhance
More informationAdvanced parameters offer faster, surer guidance to cancer care
Advanced parameters offer faster, surer guidance to cancer care captodayonline.com /advanced-parameters-offer-faster-surer-guidance-cancer-care/ Anne Paxton 9/18/2017 September 2017 After a career spent
More informationYear 2003 Paper two: Questions supplied by Tricia
QUESTION 65 A 36-year-old man presents in a post-ictal state after an observed generalised seizure. Full blood investigation shows: haemoglobin 0 g/l [128-175] mean corpuscular volume (MCV) 106 fl [80-7]
More informationContinuing Education Questions
FOCUS: INTERPRETING THE COMPLETE BLOOD COUNT Continuing Education Questions SUMMER 2017 1. A methodical approach to CBC interpretation that is aimed at medical laboratory professionals differs from one
More informationInterpreting the CBC. Robert Miller PA Assistant Professor of Clinical Pediatrics and Family Medicine USC Keck School of Medicine Retired
Interpreting the CBC Robert Miller PA Assistant Professor of Clinical Pediatrics and Family Medicine USC Keck School of Medicine Retired The CBC 3 Cell Lines RBCs WBCs Platelets Assess general health Make
More informationNationwide Children s Hospital
Implementing IPF and RET He: Clinical Applications in a Pediatric Setting Gretchen Dennis MT(ASCP) cm, MLS(ASCP) Technical Specialist Routine Hematology Nationwide Children s Hospital 1 We have been growing!
More informationXN-SERIES. Hematology Case Studies: Every Picture Tells a Story
Hematology Case Studies: Every Picture Tells a Story Jill Crist MT(ASCP)Field Product Specialist OBJECTIVES Explain how scattergrams and histogram pictures can provide great insight into abnormal hematology
More informationPrecision and Accuracy of the Leukocyte Differential on the Sysmex XE-2100
Precision and Accuracy of the Leukocyte Differential on the Sysmex XE-2100 R. HERKLOTZ and A. R. HUBER Zentrum für Labormedizin, Kantonsspital Aarau, 5001 Aarau, Switzerland. The automated leukocyte(wbc)
More informationHematology: Challenging Cases with Your Participation COPYRIGHT
Hematology: Challenging Cases with Your Participation Reed E. Drews, MD Beth Israel Deaconess Medical Center Harvard Medical School Boston, MA Question 1 Question 1 64-year-old man is evaluated during
More informationCollect and label sample according to standard protocols. Gently invert tube 8-10 times immediately after draw. DO NOT SHAKE. Do not centrifuge.
Complete Blood Count CPT Code: CBC with Differential: 85025 CBC without Differential: 85027 Order Code: CBC with Differential: C915 Includes: White blood cell, Red blood cell, Hematocrit, Hemoglobin, MCV,
More informationClinical implications for decreased lymphocytes (lymphopenia) o Corticosteroid therapy, adrenocortical hyperfunction, stress, shock
Learning Objectives At the completion of this program, the participants will be able to: 1. Identify the components of the CBC and Differential and their clinical implications. 2. Identify normal pediatric
More information10/30/2015. XN Case Studies: Every Picture Tells a Story
XN Case Studies: Every Picture Tells a Story Jill Crist MT(ASCP)Field Product Specialist OBJECTIVES Explain how scattergrams and histogram pictures can provide great insight into abnormal hematology samples
More informationCASE STUDIES PERIPHERAL BLOOD AND BODY FLUIDS
CASE STUDIES PERIPHERAL BLOOD AND BODY FLUIDS WHERE TO START anemias hemoglobinopathies new and old parameters uncommon things fluids.benign and malignant.yuk! really annoying stuff and maybe some entertainment
More informationIntroduction to Haematology. Prof Roger Pool Department of Haematology University of Pretoria
Introduction to Haematology Prof Roger Pool Department of Haematology University of Pretoria Suggested reading Haematology at a Glance Atul Mehta & Victor Hoffbrand Second Edition Published by Blackwell
More informationAbnormal blood counts in children Dr Tina Biss Consultant Paediatric Haematologist Newcastle upon Tyne Hospitals NHS Foundation Trust
Abnormal blood counts in children Dr Tina Biss Consultant Paediatric Haematologist Newcastle upon Tyne Hospitals NHS Foundation Trust Regional Paediatric Specialty Trainees teaching 4 th July 2017 Scope
More informationEvaluation of the Diagnostic Performance of the Sysmex XT-2000i Automated Hematology Analyzer in the Detection of Immature Granulocytes
Evaluation of the Diagnostic Performance of the Sysmex XT-2000i Automated Hematology Analyzer in the Detection of Immature Granulocytes A. M. CENCI *1, M. MACONI *2, and B. CASOLARI *1 *1 Laboratory of
More informationHISTOLOGY VIRTUAL LABORATORY BLOOD AND LYMPHATICS SYSTEM
HISTOLOGY VIRTUAL LABORATORY BLOOD AND LYMPHATICS SYSTEM Login: http://histopath.westernu.edu Histology Atlas AND Virtual Histology links. I. HEMATOLOGY - PERIPHERAL BLOOD Purpose: To be able to identify
More informationDifferential Blood Smear H3
Verein für Association pour le Associazione per il medizinische Qualitätskontrolle contrôle de qualité médical controllo di qualità medico Report Differential Blood Smear H3 MQ 2018-1 MQ, Institut für
More information9/23/2018. Hematology Case Studies Jason Anderson, MPH, MT(ASCP) Field Product Specialist OBJECTIVES FLUORESCENT FLOW CYTOMETRY
Hematology Case Studies Jason Anderson, MPH, MT(ASCP) Field Product Specialist OBJECTIVES Discuss how scattergram and histogram pictures can provide insight into abnormal hematology samples Utilize case
More informationCustomer Information Literature List Platelets
Customer Information Literature List Platelets Date: August 2015 Subject: Literature List Platelets Issued by: Scientific Customer Services Number: 150803 Note: Whether references are given in British
More informationImpact of Integrating Rumke Statistics to Assist with Choosing Between Automated Hematology Analyzer Differentials vs Manual Differentials
Impact of Integrating Rumke Statistics to Assist with Choosing Between Automated Hematology Analyzer Differentials vs Manual Differentials Laura Stephens, 1 Wendy Hintz-Prunty, 1 Hans-Inge Bengtsson, 2
More informationSue Jung Kim, MD, MS; Yoonjung Kim, MD; Saeam Shin, MD; Jaewoo Song, MD, MS; Jong Rak Choi, MD, PhD
Comparison Study of the Rates of Manual Peripheral Blood Smear Review From 3 Automated Hematology Analyzers, Unicel DxH 800, ADVIA 2120i, and XE 2100, Using International Consensus Group Guidelines Sue
More informationDR SUDHIR MEHTA MD,MNAMS,FICP. Senior Professor & Head Medical Unit SMS Medical College & Hospital Jaipur
DR SUDHIR MEHTA MD,MNAMS,FICP Senior Professor & Head Medical Unit SMS Medical College & Hospital Jaipur s.smehta@hotmail.com CBC..What is the Utility of performing this basic Hematology Test? 10/31/2010
More informationADVANCED HAEMATOLOGY BATTLE OF THE BANDS. Dennis B. DeNicola, DVM, PhD, DACVP IDEXX Laboratories, Inc. Westbrook, Maine, USA BACKGROUND
ADVANCED HAEMATOLOGY BATTLE OF THE BANDS Dennis B. DeNicola, DVM, PhD, DACVP IDEXX Laboratories, Inc. Westbrook, Maine, USA BACKGROUND The identification of immature neutrophils (bands, metamyelocytes,
More informationSysmex Journal International Vol.9 No.2 (1999)
Sysmex Journal International Vol.9 No. (999) Evaluation and Clinical Usefulness of the Automated Hematology Analyzer, Sysmex XE- TM Kazuto TSURUDA, Tomohiro TSUJI, Tetsuya USUI, Sachiko KITAJIMA, Atsuko
More informationHAEMATOLOGICAL EVALUATION OF ANEMIA. Sitalakshmi S Professor and Head Department of Clinical Pathology St John s medical College, Bangalore
HAEMATOLOGICAL EVALUATION OF ANEMIA Sitalakshmi S Professor and Head Department of Clinical Pathology St John s medical College, Bangalore Learning Objectives Laboratory tests for the evaluation of anemia
More informationAuto Validation and Management Reports Using Sysmex WAM. Alfonso Ziccardi Laboratory Operation Manager for AP/CP/Safety Officer
Auto Validation and Management Reports Using Sysmex WAM Alfonso Ziccardi Laboratory Operation Manager for AP/CP/Safety Officer SUCCESS BEYOND FINANCES Hematology Testing Breakdown NYHQ Descrete testing
More informationNEW HEMATOLOGY PARAMETERS
NEW HEMATOLOGY PARAMETERS CASE STUDIES and IMPLEMENTATION WHAT WE WILL COVER new parameters Ret-He, IPF (and some not so new parameters) - anemias - hemoglobinopathies - problem platelets - uncommon things
More informationGuide to the 1-3 Minute Blood Film Microscopic Review: Why and How?
Guide to the 1-3 Minute Blood Film Microscopic Review: Why and How? Dennis B. DeNicola, DVM, PhD, DACVP Chief Veterinary Educator IDEXX Laboratories, Inc. Westbrook, ME USA Adjunct Professor of Veterinary
More information3. Blood Cell Histograms:
LECTURE MODULE 6c: ELECTRONIC CELL COUNTING PART III 3. Blood Cell Histograms: a. The Coulter cell counters today provides size distributions of the cellular content: 1) volume given in µm 3 or fl vs relative
More informationAvoiding Early Cancer Claims. Presentation #4. Hank George, FALU
Avoiding Early Cancer Claims Presentation #4 Hank George, FALU Hematology and High Risk of Early Cancer Claims Mild Anemia in elders is underpriced by insurers most likely because of its high prevalence
More informationThe Evolving Role of Reticulated Platelets
The Evolving Role of Kyle Riding, PhD, MLS(ASCP) CM University of Central Florida Session Objectives Platelets Recall the process involved in megakaryopoiesis and thrombocytopoiesis Explain the various
More informationAutomated Hematology Analyzer. Differentiate with the XT-4000i
XT-4000i Automated Hematology Analyzer Differentiate with the XT-4000i Advanced Technology Solutions to Meet Your Lab s Needs Even with these challenges, the need for hematology testing has remained steady
More informationVision Hema. Additional modules
Vision Hema Additional modules Vision Hema RTC Digital morphology of reticulocytes Innovative solution for the study of reticulocytes Reticulocytes Reticulocytes young erythrocytes that appear in the bone
More information2007 Workshop of Society for Hematopathology & European Association for Hematopathology Indianapolis, IN, USA Case # 228
2007 Workshop of Society for Hematopathology & European Association for Hematopathology Indianapolis, IN, USA Case # 228 Vishnu V. B Reddy, MD University of Alabama at Birmingham Birmingham, AL USA 11/03/07
More informationLeukocytosis - Some Learning Points
Leukocytosis - Some Learning Points Koh Liang Piu Department of Hematology-Oncology National University Cancer Institute National University Health System Objectives of this talk: 1. To provide some useful
More informationCustomer Information Literature List White Blood Cells
Customer Information Literature List White Blood Cells Date: September 2015 Subject: Literature List White Blood Cells Issued by: Scientific Customer Services Number: 150901 Note: Whether references are
More informationClinical use of flow cytometry
Clinical use of flow cytometry Diagnosis of leukemia Combined use of intracellular staining and a cell surface marker Detection of stem cells CD34+ stem cells Monitoring of stem cell count following
More informationCbc with differential
Cbc with differential Other tests might be necessary based on the results of the differential test and follow-up tests. Your doctor has many ways of determining and treating causes of abnormal blood cell
More informationDoes Morphology Matter in 2017
Does Morphology Matter in 2017 ISLH May 2017 Kathryn Foucar Distinguished Professor Emerita kfoucar@salud.unm.edu Objectives Recognize unique RBC and WBC abnormalities in non-neoplastic disorders Learn
More informationOrdering Physician CLIENT,CLIENT. Collected REVISED REPORT
HPWET Hematopathology Consultation, MML Embed Client Hematopathology Consult REVISED INAL DIAGNOSIS Interpretation Peripheral blood, bone marrow aspirate and biopsies, bilateral iliac crests: 1. Normocellular
More informationRapid Laboratories In House Tests
Electrolytes CL CL (CHLORIDE) Electrolytes CO2 CO2 (BICARBONATE) Electrolytes K K (POTASSIUM) Electrolytes NA NA (SODIUM) Basic Metabolic Panel (BMP) GLU GLU (GLUCOSE) Basic Metabolic Panel (BMP) CA CA
More informationPerformance evaluation of Celltac G: a new automated hematology analyzer
Original Article Performance evaluation of Celltac G: a new automated hematology analyzer Masaaki Sugiyama 1, Tsukasa Kobayashi 1, Yuki Jisyage 2, Shigeko Yamamoto 2, Yutaka Nagai 2,3 and Hiroshi Kondo
More informationComplete Blood Count PSI AP Biology
Complete Blood Count PSI AP Biology Name: Objective Students will examine how the immunological response affects molecules in the blood. Students will analyze three complete blood counts and create diagnoses
More informationThe Complete Blood Count
The Complete Blood Count (Cartesian Thinking at Its Best) A SEM Image of Normal Human Blood Laurie Larsson February 22, 2010 Anatomy and Philology II Dr. Danil Hammoudi Introduction A complete blood count
More informationUse of the XE-2100 in a Patient with Cold Auto-immune Hemolytic Anemia
Use of the XE-21 in a Patient with Cold Auto-immune Hemolytic Anemia Gudrun STAMMINGER and Lothar BEIER Klinikum Chemnitz ggmbh, Institut für Laboratoriumsmedizin, Flemmingstraße 2, Chemnitz, Germany.
More informationBrief Communication Diagnostic Hematology
Brief Communication Diagnostic Hematology Ann Lab Med 2016;36:244-249 http://dx.doi.org/10.3343/alm.2016.36.3.244 ISSN 2234-3806 eissn 2234-3814 Establishment of Age- and Gender-Specific Reference Ranges
More informationAnemia. A case-based approach. David B. Sykes, MD, PhD Hematology, MGH Cancer Center June 8, 2017
Anemia A case-based approach David B. Sykes, MD, PhD Hematology, MGH Cancer Center June 8, 2017 Recognizing trends Learning Objectives MCV, RDW, Ferritin, LDH, Reticulocytes Managing complex patients 1.
More informationGetting Beyond the Flags: Quantitative assessment of immature granulocyte (IG) populations may improve the assessment of sepsis and inflammation.
Getting Beyond the Flags: Quantitative assessment of immature granulocyte (IG) populations may improve the assessment of sepsis and inflammation. Sysmex America White Paper One Nelson C. White Parkway,
More informationBlood DLC, Retic count, PCV, Hb and ESR. Dr. Tamara Alqudah
Blood DLC, Retic count, PCV, Hb and ESR Dr. Tamara Alqudah Differential Leukocyte Count (DLC) There are 5 main types of WBCs: 1. Neutrophils: 40-80% 2. Eosinophils: 1-6 % 3. Basophils: < 1-2% 4. Lymphocytes:
More informationWHITE PAPER IMMATURE GRANULOCYTE (IG) POPULATIONS MAY IMPROVE THE ASSESSMENT OF INFECTION AND SEPSIS. Getting beyond the flags.
WHITE PAPER IMMATURE GRANULOCYTE (IG) POPULATIONS MAY IMPROVE THE ASSESSMENT OF INFECTION AND SEPSIS. Getting beyond the flags www.sysmex.com/us Introduction For many decades, physicians have relied on
More informationCELL-DYN Strength in Technology, Proven Reliability. Optical WBC Technology. Patented M.A.P.S.S. Differential. Multiple Technologies
CELL-DYN 3700 Strength in Technology, Proven Reliability Optical WBC Technology Patented M.A.P.S.S. Differential Multiple Technologies CELL-DYN 3700 Multiple Technologies One Superior Result Multiple Technologies
More informationHow To Do A Manual White Blood Cell Count Up After Chemo
How To Do A Manual White Blood Cell Count Up After Chemo Typically, the greatest impact is on white blood cells. Before, during, and after chemotherapy, do your best to follow the common-sense Before you
More informationAnemia 1: Fourth year Medical Students/ October/21/ 2015/ Abdallah Abbadi.MD.FRCP Professor
Anemia 1: Fourth year Medical Students/ October/21/ 2015/ Abdallah Abbadi.MD.FRCP Professor Email: abdalla.awidi@gmail.com Main Hematological diseases A- Benign Hematology 1- Anemias 2- Bleeding disorders
More informationExam 1 Review. Cardiopulmonary Symptoms Physical Examination Clinical Laboratory Studies
Exam 1 Review Cardiopulmonary Symptoms Physical Examination Clinical Laboratory Studies WBC Count Differential A patient had been admitted to the hospital for acute shortness of breath. A CXR examination
More informationQuality control in the hematology laboratory for the sake of the patient. Dr Marion Münster Manager Medical & Scientific Affairs Sysmex South Africa
Quality control in the hematology laboratory for the sake of the patient Dr Marion Münster Manager Medical & Scientific Affairs Sysmex South Africa The FBC. Most frequently requested lab test Usually delegated
More informationPerformance Evaluation of the CellaVision DM96 System WBC Differentials by Automated Digital Image Analysis Supported by an Artificial Neural Network
Hematopathology / DIGITAL IMAGE ANALYSIS IN HEMATOLOGY Performance Evaluation of the CellaVision DM96 System WBC Differentials by Automated Digital Image Analysis Supported by an Artificial Neural Network
More informationA Practical Approach to Leukopenia/Neutropenia in Children. Vandy Black, M.D., M.Sc., FAAP OLOL Children s Hospital August 24, 2014
A Practical Approach to Leukopenia/Neutropenia in Children Vandy Black, M.D., M.Sc., FAAP OLOL Children s Hospital August 24, 2014 Disclosures EPIC trial MAST Therapeutics SUSTAIN trial Selexys Pharmaceuticals
More informationPlatelet and WBC disorders
Division of Family Practice Platelet and WBC disorders Adrian Yee MD FRCPC Clinical hematologist Assistant Dean, undergraduate education, IMP asyee@uvic.ca When we understand that slide, we'll have won
More informationThe Irony of Anemia How to interpret the CBC
Jaideep Shenoi MD Hematology Oncology Northwest Medical Specialities Tacoma, WA The Irony of Anemia How to interpret the CBC March 10 th, 2018 Disclosures: Advisory Board for Pharmacyclics, Janssen, Takeda,
More informationMyelodysplastic Syndromes: Everyday Challenges and Pitfalls
Myelodysplastic Syndromes: Everyday Challenges and Pitfalls Kathryn Foucar, MD kfoucar@salud.unm.edu Henry Moon lecture May 2007 Outline Definition Conceptual overview; pathophysiologic mechanisms Incidence,
More informationEvaluation of Anemia. Md. Shafiqul Bari Associate professor (Medicine) SOMC
Evaluation of Anemia Md. Shafiqul Bari Associate professor (Medicine) SOMC Definition Anemia is operationally defined as a reduction in one or more of the major RBC measurements Hemoglobin concentration
More informationAnemia in the elderly. Nattiya Teawtrakul MD., PhD
Anemia in the elderly Nattiya Teawtrakul MD., PhD Contents Definition of anemia in the elderly The impact of anemia in the elderly Etiology of anemia in the elderly Management of anemia in the elderly
More informationLaboratory for diagnosis of THALASSEMIA
SCBM343 CLINICAL PATHOLOGY 2(1-2-3) Laboratory for diagnosis of THALASSEMIA PORNTHIP CHAICHOMPOO pornthip.chh@mahidol.ac.th Acknowledgements Dr. Pranee Winichagoon Fucharoen Ms. Pornnapa Khampan Thalassemia
More informationThe importance of thrombocytopenia and its causes
SYSMEX EDUCATIONAL ENHANCEMENT AND DEVELOPMENT NO 4 2017 SEED HAEMATOLOGY The importance of thrombocytopenia and its causes Key words: Thrombocytopenia, thrombocytopenic, low levels of platelets What is
More informationSB 6331 (scanned slide available) Keith Duncan; Mills-Peninsula Hospital 52-year-old male with painful right parotid mass.
SB 6331 (scanned slide available) Keith Duncan; Mills-Peninsula Hospital 52-year-old male with painful right parotid mass. SB 6332 Shyam Raghavan/Don Born; Stanford 77-year-old male with right
More informationFBC interpretation. Dr. Gergely Varga
FBC interpretation Dr. Gergely Varga #1 71 Y/O female, c/o weakness Test Undertaken : FBC (FBC) Sample Type: Whole Blood [ - 26.09.11 14:59] Hb 7.3 g/dl* 12.0-15.5 RBC 3.5 10^12/l * 3.80-5.60 Hct 0.24
More informationThe Value-Driven Laboratory. The Role of the Immature Platelet Fraction (IPF) in the Differential Diagnosis of Thrombocytopenia
The Value-Driven Laboratory The Role of the Immature Platelet Fraction (IPF) in the Differential Diagnosis of Thrombocytopenia Sysmex America White Paper 577 Aptakisic Road Lincolnshire, IL 669 USA www.sysmex.com
More informationHEMATOLOGIC MORPHOLOGY- AECOM HEMATOLOGY COURSE
Log Out Help current login :lcytryn@montefiore.org HEMATOLOGIC MORPHOLOGY- AECOM HEMATOLOGY COURSE Lawrence Cytryn, M.D. - Course Director 1998 Edward Burns, M.D. Images used by permission within AECOM
More informationMECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS LYMPHOMA. April 16, 2008
MECHANISMS OF HUMAN DISEASE: LABORATORY SESSIONS LYMPHOMA April 16, 2008 FACULTY COPY GOAL: Learn the appearance of normal peripheral blood elements and lymph nodes. Recognize abnormal peripheral blood
More informationValidation of Criteria for Smear Review Following Automated Blood Cell Analysis in Ain Shams University Laboratory
Validation of Criteria for Smear Review Following Automated Blood Cell Analysis in Ain Shams University Laboratory Azza S Eldanasoury 1, Noha H Boshnak 2, Raghda E Abd El Monem 3 1 MD, Professor of Clinical
More informationHematopathology Case Study
www.medfusionservices.com Hematopathology Case Study CV3515-14 JUNE Clinical Presentation: Clinical Information: A 42 year old male with history of chronic myelogenous leukemia (CML) presents with an elevated
More informationMORPHOLOGY OF BONE MARROW ASPIRATES. Dr.Prasanna N Kumar Head Department of Pathology, Oman Medical College, Oman
MORPHOLOGY OF BONE MARROW ASPIRATES Dr.Prasanna N Kumar Head Department of Pathology, Oman Medical College, Oman BONE MARROW ASPIRATION Sites Sternum Anterior or posterior iliac spines Aspiration from
More informationBor-Sheng Ko. Hematology Division, Department of Internal Medicine, National Taiwan University Hospital
Bor-Sheng Ko Hematology Division, Department of Internal Medicine, National Taiwan University Hospital On behalf of Members of Aplastic Anemia Consensus Meeting Diagnosis and classification: Treatment
More information