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DYMIND DH76 (DYMIND BIOTECH, China) is a new automated hematology system designed to provide CBC count, including a 5-part WBC differential count, and its analytical performance should be assessed before adoption for clinical use.The analyzer was evaluated according to the International Council for Standardization in Haematology guideline. The purposes of this study were to assess its analytical performance in comparison to SYSMEX XN 1000 hematology analyzer currently used in our laboratory, as well as to compare the automated and manual WBC differential.Within-run precision in all concentration ranges was very good with coefficients of variation (CVs) between 0.02% and 2.5% except for platelets over 500×109/L (CV 9.5%). Within-batch imprecision showed CVs lower the declared deviation ranges. Accuracy (defined as trueness) was excellent for all CBC and white cell differential parameters, compared with the state of the art%. Linearity was confirmed with excellent regression coefficients (0.999-1.000), even in the lowest values, and carryover was ≤ 1%. Comparison between DYMIND DH76 and SYSMEX XN 1000 was also very good with correlation coefficients (R2) for WBC (1.000), RBC (0.999), hemoglobin (0.999) and PLT over 50×10With excellent analytical performance and acceptable comparative analysis, DYMIND DH76 hematology analyser covered the predefined international standards and requirements and is fully appropriate for clinical application.DYMIND DH76 (DYMIND BIOTECH, Kina) je novi automatski hematološki sistem napravljen da pokaže broj CBC, uključujući petodelni diferencijalni broj WBC. Pre ulaska u kliničku upotrebu, potrebno je da se ispitaju njegove analitičke performanse.U ocenjivanju analizatora korišćene su smernice Međunarodnog saveta za standardizaciju u hematologiji. Svrha ove studije je bila procena njegovih analitičkih performansi u odnosu na hematološki analizator SYSMEX XN 1000 koji se trenutno koristi u našoj laboratoriji, kao i da se uporedi automatski i ručni WBC diferencijal.Preciznost u toku ispitivanja u svim rasponima koncentracija je bila vrlo dobra sa koeficijentima varijacije (CV) između 0,02% i 2,5%, osim za trombocite preko 500×109/L (CV 9,5%). Nepreciznost unutar serije je pokazala da CV smanjuje deklarisani opseg odstupanja. Tačnost (definisana kao istinitost) je bila odlična za sve CBC i diferencijalne parametre belih ćelija, u poređenju sa procentom vrhunske tačnosti. Linearnost je potvrđena odličnim koeficijentima regresije (0,999-1,000), čak i u najnižim vrednostima, a prenos je bio ≤ 1%. Poređenje između DYMIND DH76 i SYSMEX XN 1000 je takođe bilo vrlo dobro sa koeficijentima korelacije (R2) za WBC (1,000), RBC (0,999), hemoglobin (0,999) i PLT preko 50×109/L (0,994), i R2 je bio niži, ali i dalje prihvatljiv (0,910) za PLT50x109/L. R2 za neutrofile, limfocite, eozinofile, bazofile i monocite je bio redom 0,974; 0,982; 0,957; 0,625 i 0,836 u poređenju između ručnog i DYMIND DH76 automatskog diferencijalnog broja WBC.Sa odličnim analitičkim performansama i prihvatljivom uporednom analizom, hematološki analizator DYMIND DH76 je pokrivao unapred definisane međunarodne standarde i zahteve i u potpunosti je pogodan za kliničku primenu.

African trypanosomosis is a disease of high economic importance in animals and humans caused by an apicomplexan haemoparasite of the genus Trypanosoma. Canine trypanosomosis is relatively common in Nigeria because of the high prevalence of the insect vector. The haematology, erythrocyte, and serum sialic acid levels of dogs experimentally infected with Federe strain of Trypanosoma brucei brucei was studied in a total of five (5) 4-month old dogs. Three of the dogs were randomly selected and inoculated subcutaneously with 1 × 106 of T. brucei, while the remaining two dogs served as the uninfected control. The parasitaemia, packed cell volume (PCV), total and differential white blood cell count, erythrocyte surface sialic acid (ESSA) and free serum sialic acid (FSSA) were determined twice a week. The lymphocyte/monocyte ratio (LMR) and neutrophil/lymphocyte ratio (NLR) were calculated. The infected dogs had a significantly lower PCV, total white blood cell count (TWBC), LMR and ESSA compared to the uninfected control group. There was a strong positive correlation between NLR and PCV decrease, moderate negative correlation between LMR and PCV decrease, strong negative correlation between LMR and ESSA changes, and a moderate positive correlation between ESSA changes and parasitaemia. The higher NLR in trypanosome infection associated with decreasing levels of PCV indicates a poor prognosis, and NLR may be a useful tool in estimating trypanosomosis effect on PCV in dogs. Similarly, the moderate negative and strong negative correlations between LMR with decreases in PCV and ESSA respectively indicates poor prognosis in the response to trypanosomosis in dogs. Thus, NLR, LMR and ESSA levels can be used as markers for predicting disease outcome in trypanosome infection in dogs. This is, however, not the case with parasitaemia as the clinico-pathologic effect of trypanosomosis cannot be estimated from the level of parasitaemia alone.

The purpose of the research is assessment of karyopathic effect and general safety of Trichinella spiralis and Echinococcus multilocularis protein extracts in mice.Materials and methods. To assess the karyotic effect bone marrow cells were isolated and preparations were prepared using a metaphase method (Ford C. E., Hamerton J. L., 1956). Cytological analysis of bone marrow smears was performed to determine the white cell lineage counts. The main hematological indices of mice were determined at hematological analyzer «Abacus JuniorVet» («Diatron», Austria); differential white blood cell count was analyzed using common method. Blood biochemical indices were determined at biochemical analyzer A-15/25 (BioSystems S.A., Spain).Results and discussion. The intraperitoneal administration of T. spiralis and E. multilocularis protein extracts induced K-mitosis in mice bone marrow cell population. Systemic disorders associated with that cytogenetic effect and general reaction of organism to administration of protein extracts, in particular changes in bone marrow white cell lineage counts and peripheral blood indices were revealed. T. spiralis and E. multilocularis protein products showed some negative effects on liver and kidney function in mice.

Haemoparasites are either intracellular or extracellular organisms that inhabit the blood stream of vertebrate hosts. This study was conducted in Zaria Nigeria inorder to investigate the prevalence of haemoparasites in polo horses and their effects on haematological parameters. Blood samples were collected from a total of 100 randomly selected horses from polo stables across Zaria. The blood samples were screened and examined using thin blood smear, buffy coat technique, and differential white blood cell count. From the results thirteen horses 100(13%) were found infected with haemoparasites. The prevalence of Theileria equi in local and exotic breeds was 5(9.4%) and4 (8.5%) while for microfilaria it was 3(5.3%) and1 (2.1%). There were no Babesia or Trypanosomes found in the samples 0%. Among sexes the prevalence of Theileria equi and microfilaria in males was 1(7.7%) while in females it was (9.3%) and 3(3.4%).A high prevalence of Theileria equi and microfilaria was seen among old horses 6(9.3%) and4 (3.4%) compared to young 3(7.7%) and1 (7.7%).There was no significant association between the presence of the infection and its effect on haematological values (p>0.05). In conclusion some haemoparasites were found in polo horses in Zaria. It is hereby recommended that routine vector control and prophylactic treatment should be carried out in stables

Background Alinity hq (Abbott) is a new high-throughput hematology analyzer that exclusively employs optical principles for detecting and enumerating blood cells. It reports 29 parameters, including a six-part white blood cell (WBC) differential. The aim of this multicenter study was to evaluate the analytical and clinical performance of the Alinity hq. Methods Complete blood count (CBC) results and morphological flagging were compared to that of CELL-DYN Sapphire (Abbott) and 2 × 200-cell manual differential results, on 1473 whole-blood samples from a well-defined patient population from three different clinical laboratories in the Netherlands. In addition, within-run and within-laboratory precision, linearity, limit of quantitation, carryover and sample stability were assessed. External quality assessment samples were also evaluated. Results Data analysis demonstrated strong concordance of Alinity hq results with those of CELL-DYN Sapphire for all CBC parameters, except for basophil granulocytes. Alinity hq WBC differential showed high level of agreement with manual differential results and exhibited a better agreement with manual basophil results than CELL-DYN Sapphire. The sensitivity of the Alinity hq Blast flag was 57.6%, equal to the 57.6% sensitivity of the CELL-DYN Sapphire’s Blast Alert. When considering samples with ≥5% blasts, the sensitivity of the Alinity hq Blast flag was 70.0%. Analytical performance of Alinity hq was shown to be consistent with state-of-the-art (SOTA) performance characteristics. Conclusions Alinity hq CBC measurands demonstrated good overall agreement with results obtained with CELL-DYN Sapphire, as well as manual WBC differential. The analytical and clinical performance characteristics of Alinity hq make it well suited for clinical laboratories.

Introduction Abbott Alinity hq is a next-generation automated hematology analyzer providing complete blood count (CBC) with 6-part white blood cells (WBC) differential counts. The purpose of this study was to evaluate the performance of the analyzer to verify the diagnostic and clinical utility of the Abbott Alinity hq automated system. Methods We evaluated specimen stability, precision, linearity, carry-over, and method comparison to assess the performance of Alinity hq. For comparison of the Alinity hq with Sysmex XN-9000, totally 314 samples from adult and pediatric patients including both normal and abnormal hematology profiles were analyzed in parallel. The Alinity hq was also compared with the manual differential counts for the same 314 samples. Results At 4°C, the Alinity hq analyzer showed no significant changes in CBC and WBC differential count up to 48 hours. When stored at room temperature (18-25°C), all parameters except the mean platelet volume (MPV) were stable up to 36 hours. The Abbott Alinity hq analyzer demonstrated excellent reproducibility and between-batch precision for all CBC and WBC differential parameters. WBC, red blood cells (RBC), hemoglobin (HGB), and platelets showed good linearity and acceptable carry-over. Comparison with a Sysmex XN-9000 analyzer and manual 400-cell differential showed excellent correlation for CBC and WBC differential count parameters (correlation coefficient = 0.815-0.999) except for mean corpuscular hemoglobin concentration (MCHC) and basophils. Conclusion We performed initial validation studies and confirmed performance specifications on specimen stability, precision, linearity, carry-over, and method comparison. The Abbott Alinity hq analyzer showed good analytical performance for all standard CBC parameters.

White blood cell (WBC) differential counting is an established clinical routine to assess patient immune system status. Fluorescent markers and a flow cytometer are required for the current state‐of‐the‐art method for determining WBC differential counts. However, this process requires several sample preparation steps and may adversely disturb the cells. We present a novel label‐free approach using an imaging flow cytometer and machine learning algorithms, where live, unstained WBCs were classified. It achieved an average F1‐score of 97% and two subtypes of WBCs, B and T lymphocytes, were distinguished from each other with an average F1‐score of 78%, a task previously considered impossible for unlabeled samples. We provide an open‐source workflow to carry out the procedure. We validated the WBC analysis with unstained samples from 85 donors. The presented method enables robust and highly accurate identification of WBCs, minimizing the disturbance to the cells and leaving marker channels free to answer other biological questions. It also opens the door to employing machine learning for liquid biopsy, here, using the rich information in cell morphology for a wide range of diagnostics of primary blood. © 2019 The Authors. Cytometry Part A published by Wiley Periodicals, Inc. on behalf of International Society for Advancement of Cytometry.

Objectives A CBC with WBC differential is often ordered when a CBC alone would be sufficient for patient care. Performing unnecessary WBC differentials adds to costs in the laboratory. Our objective was to implement a laboratory middleware algorithm to cancel repeat, same-day WBC differentials to achieve lasting improvements in laboratory resource allocation. Methods Repeat same-day WBC differentials were first canceled only on intensive care unit samples; after a successful trial period, the algorithm was applied hospital-wide. We retrospectively reviewed CBC with differential orders from pre- and postimplementation periods to estimate the reduction in WBC differentials and potential cost savings. Results The algorithm led to a monthly WBC differential cancellation rate of 5.40% for a total of 10,195 canceled WBC differentials during the cumulative postimplementation period (September 25, 2019, to December 31, 2020). Nearly all (99.94%) differentials remained canceled. Most patients only had one WBC differential canceled (range, 1-38). Savings estimates showed savings of $0.99 CAD per canceled differential and 1,060 minutes (17.7 hours) of technologist time. Conclusions A middleware algorithm to cancel repeat, same-day WBC differentials is a simple and sustainable way to achieve lasting improvements in laboratory utilization.

BACKGROUND: Elevated white blood cell (WBC) count in tobacco cigarette smokers compared to non-smokers has been well documented, but little is known on circulating WBC counts and cannabis use. METHODS: The National Health and Nutrition Examination Survey (2005–2016) is designed to be nationally representative of United States non-institutionalized population. The current study includes adult participants 20–59 years of age (n= 16,430) who underwent a detailed examination in the mobile examination center (MEC). Cannabis use was measured using Audio Computer-Assisted Self-Interview. Cannabis use was classified into never, former, occasional (1–7 days of the past 30 days), and heavy (>7 days of the past 30 days). WBC count was measured using the Coulter Counter method. RESULTS: Total WBC count was higher among heavy cannabis users when compared to never users (β = 189; 95% confidence interval: 74, 304, p = 0.001). Among circulating WBC types, modest differences were observed for neutrophil count. Neither former nor occasional cannabis use was associated with total or differential WBC counts. CONCLUSIONS: A modest association between heavy cannabis use and WBC count was detected. Additional research is needed to understand the immune related effects of different modes of cannabis use and to elucidate the role of proinflammatory chemicals generated from smoking cannabis.

Background SARS-CoV-2 infection alters various blood parameters, which may indicate disease severity and thus help in better clinical management. Aim To study the association between various hematological parameters and disease severity of COVID-19. To analyze the effects of hypertension and diabetes on neutrophil-lymphocyte ratio and neutrophil-monocyte ratio in patients suffering from COVID-19. Materials and methods The study was a cross-sectional study involving 148 laboratory-confirmed cases of SARS-CoV-2 infection. The patients were divided into three groups on the basis of disease severity. Various hematological parameters were analyzed. The effects of hypertension and diabetes on NLR and NMR in COVID-19 patients were evaluated. Results Of the 148 patients, 78.4%, 8.1% and 13.5% cases were in the mild, moderate and severe groups, respectively. Mean age was 42.63 ± 16.04 years (IQR: 29, 54.75; Range: 7–74). 58.8% patients were male while the rest (42.2%) were female. Mean TLC (cells/mm3), neutrophil (%), lymphocyte (%), monocyte (%), eosinophil (%), neutrophil-lymphocyte ratio (NLR) and neutrophil-monocyte ratio (NMR) among mild, moderate and severe COVID-19 was statistically significant (p, Highlights • Leukocytosis, neutrophilia, lymphopenia, monocytopenia and eosinopenia are associated with severe COVID-19. • High neutrophil-lymphocyte ratio (NLR) and neutrophil-monocyte ratio (NMR) are indicators of disease severity in COVID-19. • Basophil count and lymphocyte-monocyte ratio (LMR) are not related with severity of illness in COVID-19. • High NLR is statistically significant (p

BACKGROUND: Diabetic ketoacidosis (DKA) is well-known to be associated with increased levels of inflammatory markers including cytokines. Interestingly, an elevated white blood count (WBC) has been associated with a higher prevalence of acute and chronic diabetes metabolic complications, including DKA, and micro- and macrovascular complications (Tong et al., 2004; Xu et al., 2013). However, very few studies have looked at the relationship between WBC differential and the severity of DKA. For instance, a study looking at platelet-to-lymphocyte ratio found it to be a significant predictor of mortality in DKA patients admitted to the intensive care unit (Liu et al., 2016). Aim: The goal of the present study is to investigate the relationship between the WBC differential and the severity of DKA. Method: This study was conducted at Dalhousie University-affiliated hospitals in Nova Scotia, Canada. Ethics approval was obtained. The medical records of 646 emergency visits for 338 patients between November 2015 to December 2018 with a provisional diagnosis of DKA were retrospectively reviewed. 84 records were excluded due to non-anion gap metabolic acidosis, and 66 were excluded due to radiological or microbiological evidence of infection (positive urine, stool or blood cultures, pneumonia, etc.). Only the first set of blood investigations were analyzed to avoid post-treatment changes in blood composition. WBC differential (neutrophils, basophils, eosinophils, immature granulocyte, lymphocytes, metamyelocytes, monocytes, and myelocytes) and severity of DKA based on pH value (mild: 7.25–7.30, moderate: 7.24-7.00, and severe: Result: A total of 496 visits for 277 patients were analyzed, with about 1:1.2 male-to-female ratio and median age of 36.5 years (range 18–90 years), with no significant differences in sex or age in relation to the severity of DKA (P-value= 0.68 and 0.16, respectively). Leukocytosis (WBC >11 x10(9)/L) was seen in 65% (n=314). 32% (n=158) had mild DKA, while 56% (n=273) and 1% (n=57) had moderate and severe DKA, respectively. With increased severity of DKA, higher WBC count and hemoglobin levels were observed (P-value= 0.002 and 0.037, respectively). This is not unexpected due to hemoconcentration. However, monocytes, immature granulocytes, and basophils (percentage unit of the total WBC) increased with the severity of DKA (P-value: 0.004, Conclusion: The WBC differential (namely, monocytes, immature granulocytes, basophils, & lymphocytes) is associated with the severity of DKA. We propose that the WBC differential be further studied as a prognostic indicator in patients with DKA.

New onset of fever is an everyday problem encountered in the ICU. The reason could be manifold such as noninfectious cause, mild infection, or an initial presentation of severe infection. This should trigger a careful clinical assessment and a systematic approach to differentiate these possibilities.

Periodontal tissue diseases, in particular, generalized periodontitis, are one of the most common problems of dentistry of the present. Determination of the peculiarities of the course of this pathology, depending on the group membership of blood of patients, in particular the data of the leukogram, will allow to develop in the future a complex of targeted, prophylactic and therapeutic measures that will improve and optimize the ways of solving this problem. The aim of our study was to find out the dynamics of the data of leukograms in patients with generalized periodontitis with different blood groups. The material and research methods. 855 males aged 20 - 55 years were examined. The total blood count was determined using an automatic hematologic analyzer. Morphological study of formed blood elements was performed using a light microscope according to a unified method. On the basis of the obtained data of "white blood" in patients of the study groups we have calculated the simplified leukocyte index of intoxication. Results of the research and their discussion. As a result of the study, it was established that in the patients with GP, carriers of O (I) and AB (IV) blood groups the quantitative composition of blood leucocytes increased the same, while in the representatives of A (II) and B (III), the blood groups were slightly smaller. The maximum increase in the neutrophil content in the blood was studied in patients with GP, carriers of AB (IV) blood group, a minimum increase was in patients with B (III) blood group, and in patients of the main group of O (I) and A (II) blood groups, the neutrophil content in the blood increased equally. The maximum increase in the value of the bands neutrophils in the blood was investigated in patients with GP with AB (IV) and A (II) blood groups, somewhat lower was the increase in the level of bands neutrophils in representatives of the O (I) blood group, and the minimum value of the analyzed data in patients with GP with B (III) blood group. The maximum reduction in lymphocytes was determined in the carriers of A (II) and AB (IV) blood groups, the level of lymphocytes in the blood of the representatives of О (I) blood group decreased somewhat less, however, in patients with B (III) blood group, the level of lymphocytes increased in the blood. The maximum reduction in the content of eosinophils in the blood was investigated from the representatives of the O (I) and AB (IV) blood groups, the level of values of the analyzed data in carriers A (II) and B (ІІІ) blood groups decreased less. The maximum increase in the content of basophils in the blood was investigated in patients with A (II) and B (III) blood groups, somewhat less increase was found in patients with the O (I) blood group, and in patients with GP, carriers of AB (IV) blood groups, level of the analyzed index in the blood was 0.70 ± 0.39% in the absence of this cell component in the study group of comparison. On average, the monocyte content in the blood of the subjects was the same in the main and comparative groups. The maximum increase in the values of the index of intoxication leukocyte was determined from the representatives of the O (I) and A (II) blood groups, and the values of the LII in patients with GP with AB (IV) and B (III) blood groups were slightly increased. Conclusions Thus, in patients with GP endogenous intoxication phenomena can be traced, which, according to the grading scale, corresponds to a slight degree of severity and is due to metabolic disorders, barrier functions of the membranes, regulatory systems, excessive presence of inflammatory mediators, and microbial toxins of immuno-foreign products. Prospects for further research. It is planned to continue the study of the course of generalized periodontitis in people with different blood groups, taking into account the correction of its polypeptide drugs.

Aim. To develop reference intervals for white blood cell subpopulations in peripheral blood using Cytomics FC500 flow cytometer and CytoDiff™ reagent (Beckman Coulter). Materials & Methods. The trial included the analysis of blood samples of healthy donors (n = 315) using Cytomics FC500 flow cytometer and CytoDiff™ reagent cocktail composed of 6 antibodies in 5 colors (CD36-FITC, CD2-PE, CD294-PE, CD19-ECD, CD16-Cy5, CD45-Cy7) and enabling to count 17 cell populations. Results. The data obtained by means of multicolor flow cytofluorometry included the reference values of white blood cell populations in peripheral blood. In 1 first-time donor a lymphoproliferative disease was detected. It was subsequently confirmed by immunophenotyping; B-cell chronic lymphocytic leukemia was diagnosed. Conclusion. Multicolor flow cytofluorometry using CytoDif-f™ is considered to be a new step toward an improved WBC differential evaluation aimed mainly at reducing the volume of blood smear analysis using light microscopy at large laboratories, enhancing objectivity, precision and reproducibility of results. WBC differential extended with the count of lymphocyte and monocyte subpopulations can be regarded as modern donor blood screening to detect changes in the pattern of lymphocyte subpopulations as grounds for further examination of donors.

Raman microspectroscopy displays a label-free and non-destructive modality providing highly specific information on single-cell level. Thus, it bears great potential as a standard tool in biomedical studies. We have developed a high-throughput screening Raman spectroscopy platform combining both automated imaging microscopy and spectra acquisition. The system allows for rapid screening of whole cell populations enabling differential white blood cell count and circulating tumor cell detection.

Development of blood smear scanner analyzers is a new promising trend in designing devices for blood cell morphology examination. The efficacy of using the Vision Hema® Ultimate scanner analyzer for differential white blood cell count and identification of nucleated blood cells was evaluated. The average time required to analyze a single cover-glass preparation was found to be (108 ± 17)″. There was no statistically significant difference between the results of differential white blood cell count performed manually and using the Vision Hema® Ultimate device (p > 0.05); the results were virtually identical. The Spearman’s correlation coefficient was highest for segmented neutrophils, lymphocytes and eosinophils (0.9638%, 0.9342%, and 0.9172%, respectively). For monocytes and basophils it was 0.9047% and 0.7613%, respectively, while its lowest values were observed for immature myeloid cells. The Vision Hema® Ultimate blood smear scanner analyzer was shown to provide high accuracy and productivity of differential white blood cell count in peripheral blood smears.

PURPOSE: Automated hematology analyzers yield a complete hematological profile including a complete blood count and a differential white blood cell count. The differential count is based on analyses of three parameters, namely, volume, conductance, and scatter (VCS). We aimed to evaluate the VCS parameters, histograms, and scatterplots of neoplastic and nonneoplastic lymphocytes. MATERIAL AND METHODS: Patients were grouped into four categories, namely, acute lymphoblastic leukemia (ALL), chronic systemic disorders, chronic lymphocytic leukemia (CLL), and acute viral disease. Lymphocytes from all four groups were compared with lymphocytes from normal participants. RESULTS AND CONCLUSIONS: The histogram for acute viral disease showed a trough at T1, which was slightly obliterated, and the F1 curve mildly extended to the right. The T1 for ALL was replaced with a peak at >40% of the preset limit. The F1 peak was shifted to left for CLL. The scatterplot for viral disease showed lymphocytes extending to the variant lymphocyte window. The lymphocytes of ALL extended to the blast window, with both increase in volume and mild increase in scatter. The lymphocytes in CLL were smaller and located below the normal lymphocyte region. Mean lymphocyte volume was significantly increased in ALL and was significantly decreased in CLL. Mean lymphocyte conductance was significantly increased in CLL and significantly decreased in both acute viral disease and ALL. Mean lymphocyte scatter was significantly decreased in acute viral disease and significantly increased in ALL.

Background Zerumbone (ZER) is a major bioactive compound of Zingiber zerumbet, a wild ginger plant that has been documented to have anti-proliferative, anti-inflammatory and anti-oxidant properties. To investigate its hepatoprotective potential, this study was designed to determine the treatment effects of ZER on acute hepatotoxicity induced by paracetamol (PCM) in rats. Methods The control group was administered with phosphate buffer solution (PBS) while the other two groups received PCM alone (1000 mg/kg) and PCM + 25 mg/kg ZER, respectively, at 0 h and 4 h after PCM injection. After 24 h, the blood and liver were collected for differential white blood cell count, liver histological observation and biochemical analysis including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total protein concentration in serum and liver. Results Treatment with ZER was found to significantly reduce ALT (P = 0.041), AST (P = 0.044) and total hepatic protein (P = 0.045) in comparison to PCM-induced rats. Rats treated with ZER exhibited the normal structure of hepatocytes with no vacuolisation or necrosis and showed significantly reduced neutrophil count (P = 0.037). This finding suggests its ability to suppress the inflammatory processes caused by PCM overdosage and decrease the hepatocytes tendency to go through necrotic processes. Conclusion ZER possessed protective activity against PCM-induced acute hepatotoxicity in a rat model.

The effect of garlic powder on blood constituents in male rabbits was studied. These constituents were hemoglobin concentration, packed cell volume, red blood cell count, total and differential white blood cell count, platelets count and red cell indices. Fifteen male rabbits were randomly divided into three groups (five animals in each group). Two groups were supplied with pellets containing 1 and 5% garlic powder. The last group was considered as control and supplied with pellets and water. The period of experiment was lasted for 21 days. The results showed that there was a significant (P≤0.05) increase in the means of hemoglobin concentration, packed cell volume, platelets count, total white blood cells count, lymphocytes count, neutrophils count and mean corpuscular hemoglobin concentration in the group treated with 5% garlic powder compared with control group, while, there was no significant differences in these mentioned parameters at the treated group with 1% garlic powder compared with control group. In addition, there was a significant (P≤0.05) increased in red blood cells count at 1% and 5% garlic powder compared with control group. On the other hand, there were no significant differences in the means of monocytes count, eosinophils count, basophils count, mean corpuscular hemoglobin and mean cell volume in the treated groups with 1% and 5% garlic powder compared with control group.

Introduction: Automated body fluid (BF) analysis is gradually replacing the traditional methods of cell counting in all BFs. This study was done to analyze the high-fluorescence (HF)-BF parameter generated on Sysmex XN-1000 and study its correlation with the presence of malignant cells in the body fluids. A correlation between manual and automated differential counts was also done. Materials and Methods: A total of 1985 samples including 797 ascitic fluids (AF), 532 pleural fluids (PF), and 656 cerebrospinal fluids (CSF) were run on Sysmex XN-1000 in BF mode and cytopathology was available for 924 BFs including 389 AF, 379 PF, and 156 CSF. Both manual and automated methods were used for cell differential and cell morphology. Results: Of the 924 samples with corresponding cytopathology, malignancy was found in 59 samples. The HF-BF%/100 WBCs (24.8 ± 72.5) and HF-BF#/μL (329.86 ± 932.35) for malignant BF samples were found to be significantly higher than the nonmalignant samples (4.41 ± 8.1) and (19.57 ± 61.91), respectively. Receiver–operator-characteristic curve cutoffs for all BF for percentage and absolute HF-BF were 2.85%/100 WBCs and >12/μL. A good correlation was found between the manual and automated WBC differential counts in all fluids except CSF with total count < 5/μL. Conclusions: BFs can be reliably analyzed on automated analyzers. HF-BF parameter is helpful in identifying malignant samples but cannot be totally relied upon. If HF-BF%/# are above the lab-generated cutoffs, microscopy should be done. A complete validation study on HF-BF parameter in BF mode is desired to set the standards for the analysis of serious effusions.

International audience

Background: In coronavirus disease 2019 (COVID-19), the excessive inflammation is known to cause changes in blood parameters including differential white blood count and derived ratios such as neutrophil–lymphocyte ratio (NLR) and lymphocyte–monocyte ratio (LMR). Aim: To compare and analyze the association between differential white blood cell count and COVID-19 disease severity and mortality. Materials and methods: The study was a retrospective, observational study including 508 patients with confirmed COVID-19. Patients were divided into three groups based on severity. The laboratory parameters of all patients were collected and analyzed. Results: Among 508 patients, 75.6% were in mild, 9.1% were in moderate, and 15.4% were in severe categories. About 5.5% of the patients died during the treatment. The mean age of patients who got discharged was 42.47 ± 17.32 years and mean age of those who have died was 66.46 ± 14.37 years (P

SummaryIntroduction It is desirable in the interest of patient safety that the reporting of laboratory results should be standardized where no valid reason for diversity exists. This study considers the reporting units used for the extended blood cell count and makes a new ICSH recommendation to encourage standardization worldwide. Methods This work is based on a literature review that included the original ICSH recommendations and on data gathered from an international survey of current practice completed by 18 countries worldwide. Results The survey results show that significant diversity in the use of reporting units for the blood count exists worldwide. The use of either non-SI or other units not recommended by the ICSH in the early 1980s has persisted despite the guidance from that time. Conclusion The diversity in use of reporting units occurs in three areas: the persistence in use of non-SI units for RBC, WBC and platelet counts, the use of three different units for haemoglobin concentration and the manual reporting of WBC differential, reticulocytes and nucleated RBCs when the latter are available from automated analysis or can be expressed as absolute numbers by calculation. A new recommendation with a rationale for each parameter is made for standardization of the reporting units used for the extended blood count.

International audience; Objectives - WBC differentials performed using flow cytometry with monoclonal antibodies have been developed in the last decade and are nowadays integrated into the routine workflow of some laboratories. Definition of reference values for each population is required in order to achieve an automatic validation of the results by laboratory software. Methods - We analyzed 584 samples from three hospitals using the Hematoflow solution to define the reference values. Results - Reference values are presented for five groups according to age (0-5, 6-11, 12-19, 20-69, and >69 years). Conclusions - These normal values will be helpful in the definition of relevant threshold for the automatic validation of samples analyzed by flow cytometry and the flagging of pathologic samples.

Growing evidence suggests that stroke alters the phenotype of the peripheral immune system; better characterization of this response could provide new insights into stroke pathophysiology. In this investigation, we employed a deconvolution approach to informatically infer the cellular composition of the circulating leukocyte pool at multiple timepoints following stroke onset based on whole blood mRNA expression. Microarray data generated from the peripheral blood of 23 cardiovascular disease controls and 23 ischemic stroke patients at 3, 5, and 24 hours post-symptom onset were obtained from a public repository. Transcriptomic deconvolution was used to estimate the relative counts of nine leukocyte populations based on the expression of cell-specific transcripts, and cell counts were compared between groups across timepoints. Inferred counts of lymphoid cell populations including B-cells, CD4+ T-cells, CD8+ T-cells, γδ T-cells, and NK-cells were significantly lower in stroke samples relative to control samples. With respect to myeloid cell populations, inferred counts of neutrophils and monocytes were significantly higher in stroke samples compared to control samples, however inferred counts of eosinophils and dendritic cells were significantly lower. These collective differences were most dramatic in samples collected at 5 and 24 hours post-symptom onset. Findings were subsequently confirmed in a second dataset generated from an independent population of 24 controls and 39 ischemic stroke patients. Collectively, these results offer a comprehensive picture of the early stroke-induced changes to the complexion of the circulating leukocyte pool, and provide some of the first evidence that stroke triggers an acute decrease in eosinophil counts.

Background Hematologic variables are often analyzed in animal analogs during the investigation of complex disease etiologies such as necrotizing enterocolitis. However, reference intervals (RI) can vary depending on animal strain, age, and sampling site. Reference intervals have been published for adult C57BL/6J mice, but not newborn C57BL/6J mice. Objectives The purpose of the present study was to determine hematologic RI in newborn C57BL/6J mice up to day 35. Methods C57BL/6J mice founders from The Jackson Laboratory were bred at the University of Iowa. Blood samples were obtained via facial vein sampling at postnatal days 0 (p0), p7, p14, p21, p28, or young adulthood (p35). CBCs were determined with the Sysmex XT-2000iV analyzer within 30 minutes of blood collection at a 1:10 dilution. Statistics were determined using nonparametric methods following ASVCP guidelines. Results Hematologic RI were determined for each of the 6 groups (n = 247, n ≥ 39 per group). Significantly higher values for HGB, RBC, and PLT counts were observed with advancing developmental age. Total WBC counts remained relatively stable during the first 35 days of life. However, WBC differential counts were dominated by neutrophils and lymphocytes in the younger mice, with a trend toward a lymphocytic leukogram on day 35. Conclusions These results illustrate the dynamic changes in hematologic variables during murine development after birth. Utilization of age-specific RI is advised when evaluating data derived from experimental perinatal mouse models.

Introduction The automated XN-1000 hematology analyzer enables to perform a blood cell count and a leukocyte differential. When abnormal cells were detected, a flag was generated by the analyzer and a manual microscopic examination of the corresponding blood film was performed. Methods We compared the white blood cell differentials provided by the automated hematology analyzer XN-1000 in a pediatric population (n = 765) with those obtained through microscopic examination by cytologists and those obtained using a previous version of this analyzer, the XE-2100. Leukocytes count as well as flags sensitivity and specificity was analyzed. Results The leukocytes count provided by the analyzer is in good accordance with the differential obtained by manual count in children older than 3 months. The sensitivity for blast detection is 99% and the detection of reactive cells is 63%. The flag specificity remains low (

SummaryIntroduction The Sysmex XN modular system (Sysmex, Kobe, Japan) uses a novel technology for white blood cell (WBC) count and differential, using separate channels: white cell nucleated (WNR), WBC differential (WDF), and white progenitor cell (WPC) channels. We questioned how concordant WBC counts would be between them. Methods In a total of 6327 consecutive specimens, WBC counts were compared between WNR and WDF channels. They were also compared in three groups of WBC counts and two groups of chemotherapy status. In 508 specimens from the 4361 specimens that were run on the XN-20 module, the WPC channel was used for reflex test. Data were compared using Pearson's correlation, absolute difference, and percent difference (%D). Results WBC counts between WNR and WDF channels showed very high correlations in total specimens (r = 0.9976) and in the groups of WBC counts and chemotherapy. As WBC count increased, absolute difference increased, while %D decreased (P

The Mindray BC-5000 automated hematology analyzer is a miniature, automated hematology analyzer, and 5-part leukocyte differential counter for in vitro diagnostic use in clinical laboratories.Precision, linearity, carryover, and method comparison were carried out. The analyzer was evaluated and compared with the Sysmex XE-2100 hematology analyzer and manual microscopic in the hematology laboratory of a tertiary hospital in Chinese.There were minimal carryover (0.25%), and excellent linearity for white blood cell, and platelet counts (r0.99). Within-run precision was good at all levels for the routine cell blood count parameters (CV3.5%). Between-run precision was acceptable at all levels for the analysis parameters (CV5%) except for eosinophil and basophil (CV%10%). BC-5000 displayed very good correlation (r0.94) with the XE-2100 for cell blood count and cell differential parameters except for basophil (r = 0.72). The comparison of 258 leukocyte differential count results analyzed in parallel with manual microscopy, BC-5000 analyzer showed perfect specificity (93%) and negative predictive value (90%) on abnormal blood samples.It is concluded that the overall performance of the BC-5000 is acceptable. The miniature analyzer is suitable for use in small- to medium-size laboratories.

Rapid and accurate counts of red blood cells (RBCs), nucleated RBCs, platelets, and white blood cells (WBCs) (total and differential WBCs) are important requirements for a hematology laboratory. The detection of abnormal blood cell populations and the recognition of pathologic distributions of leukocytes are also of clinical importance. Manual microscopy counts are still required when a sample is flagged by the hematology analyzer and are still the reference method for WBC differential counts. Automated microscopy analyzers can provide accurate WBC differential counts, which may replace manual microscopy, but should not replace the eye of the cytologist.

We present a high-throughput screening Raman spectroscopy (HTS-RS) platform for a rapid and label-free macromolecular fingerprinting of tens of thousands eukaryotic cells. The newly proposed label-free HTS-RS platform combines automated imaging microscopy with Raman spectroscopy to enable a rapid label-free screening of cells and can be applied to a large number of biomedical and clinical applications. The potential of the new approach is illustrated by two applications. (1) HTS-RS-based differential white blood cell count. A classification model was trained using Raman spectra of 52 218 lymphocytes, 48 220 neutrophils, and 7 294 monocytes from four volunteers. The model was applied to determine a WBC differential for two volunteers and three patients, producing comparable results between HTS-RS and machine counting. (2) HTS-RS-based identification of circulating tumor cells (CTCs) in 1:1, 1:9, and 1:99 mixtures of Panc1 cells and leukocytes yielded ratios of 55:45, 10:90, and 3:97, respectively. Because the newly developed HTS-RS platform can be transferred to many existing Raman devices in all laboratories, the proposed implementation will lead to a significant expansion of Raman spectroscopy as a standard tool in biomedical cell research and clinical diagnostics.

International audience; Background:As conservation of whole blood samples undergoing white blood cell (WBC) differential performed by flow cytometry (Hematoflow) is needed, we evaluated the effects of two commercially available fixatives, namely TransfixTM and Streck Cell PreservativeTM.Methods:We focused on 15 normal samples and on 13 various pathological samples. We compared the two fixatives and cold- or room- temperature effects on various parameters provided by the Hematoflow system.Results:We observed that, even after 2 hours of sample treatment, the conservative methods led to significant modifications of the cell percentages due to substantial variations of the epitope expression.Conclusion:None of the different conservation methods is really reliable for WBC differential performed by flow cytometry and thus samples should be analyzed promptly or stored at 4°C.

Background: The Sysmex DI-60 system (DI-60, Sysmex, Kobe, Japan) is a new automated digital cell imaging analyzer. We explored the performance of DI-60 in comparison with Sysmex XN analyzer (XN, Sysmex) and manual count. Methods: In a total of 276 samples (176 abnormal and 100 normal samples), white blood cell (WBC) differentials, red blood cell (RBC) classification and platelet (PLT) estimation by DI-60 were compared with the results by XN and/or manual count. RBC morphology between pre-classification and verification was compared according to the ICSH grading criteria. The manual count was performed according to the Clinical and Laboratory Standards Institute guidelines (H20-A2). Results: The overall concordance between DI-60 and manual count for WBCs was 86.0%. The agreement between DI-60 pre-classification and verification was excellent (weighted κ=0.963) for WBC five-part differentials. The correlation with manual count was very strong for neutrophils (r=0.955), lymphocytes (r=0.871), immature granulocytes (r=0.820), and blasts (r=0.879). RBC grading showed notable differences between DI-60 and manual counting on the basis of the ICSH grading criteria. Platelet count by DI-60 highly correlated with that by XN (r=0.945). However, DI-60 underestimated platelet counts in samples with marked thrombocytosis. Conclusions: The performance of DI-60 for WBC differential, RBC classification, and platelet estimation seems to be acceptable even in abnormal samples with improvement after verification. DI-60 would help optimize the workflow in hematology laboratory with reduced manual workload.

Background To set up the review criteria for flow cytometry with CytoDiff (FCC) and evaluate the efficiency of different workflows using combinations of FCC with a hematology analyzer and microscopy. Methods Leucocyte differentials of the samples from 995 clinical specimens and 278 specimens from healthy donors were analyzed using a hematology analyzer, FCC, and microscopy. Results The correlations between the hematology analyzer, FCC, and microscopy were good for neutrophils, lymphocytes, and monocytes, but not in the case of basophils (r = 0.464, 0.358, 0.33) and eosinophils (r = 0.69, 0.67, 0.621). As a reference method of WBC differential using microscopy, the threshold of blasts for FCC was defined by a ROC curve at 1% (specificity 97.9%, sensitivity 97.5%, AUC 0.989). The optimal cutoff of immature granulocytes for FCC was 1% (specificity 85.8%, sensitivity 76.5%, AUC 0.866). The optimal cutoff of lymphocytes, neutrophils, and monocytes were 50%, 85% and 12%, respectively. According to the review criteria, the workflow of CBC after FCC and then microscopy had the highest sensitivity (97.07%), lower false negative rate (2.93%), and higher accuracy (80.3%) compared with others. Conclusions Our study integrated FCC into a WBC differential workflow in a routine laboratory and, for the first time, demonstrates the efficiency of different workflows. It can be used for reference in the selection of different hematology workflows.

SummaryIntroduction Pentra MS CRP is a new automated hematology analyzer that can rapidly and reliably provide 5-part differential of leukocytes (5-Diff) and C-reactive protein (CRP) within approximately 3.5 min using a small volume of whole blood (35 μL). Methods We evaluated the basic performance of Pentra MS CRP and correlations with Sysmex XN-3000, manual microscopic count, and Hitachi LABOSPECT. Results Pentra MS CRP demonstrated good repeatability and linearity without any significant carryover for all parameters examined (WBC, RBC, HGB, Hct, PLT, 5-Diff, and CRP). Complete blood cell count (CBC) data examined by Pentra MS CRP correlated well with those evaluated by Sysmex XN-3000 (R ≥ 0.9880). Absolute number of NEU, LYM, and EOS also showed the good correlation (R ≥ 0.9866) between the two analyzers. The correlation with the manual microscopic count was within acceptable criteria. Furthermore, when CRP was examined in hemolyzed whole blood by Pentra MS CRP and converted to plasma concentrations according to Hct, it correlated well (R = 0.9964) with serum CRP examined by Hitachi LABOSPECT. Conclusion Pentra MS CRP is a convenient and reliable analyzer especially in the emergency unit of hospitals in which the prompt and simultaneous measurement of CBC including 5-Diff and CRP is often necessary.

The aim of this study was to establish the reference range of hematological values for two species of Brazilian nonpoisonous snakes recently wild-caught and sent to the Butantan Institute. Blood samples were collected from the ventral caudal vein of 26 Oxyrhopus guibei (18 females and 8m ales) and 19Xenodon neuwiedii (nine females and ten males) snakes. Hematologic analyses were performed using manual standard methods and mean values (X ± SD) for O. guibei and X. neuwiedii were, respectively, red blood count ×10 9 /L (476.6±138.8 and 455.3±125.9); white blood count ×10 9 /L (4.8±2.1and 4.5±2.0); thrombocyte count ×10 9 /L (7.3±2.7 and 7.6±2.8); hematocrit % (24.3±6.0 and 23.8±6.7), hemoglobing/dL(6.8±2.3and6.3±2.0); proerythrocyte×10 9 /L (21.5±25.3 and 23.5±18.6); differential white blood cell count in ×10 9 /L: lymphocytes (1.8±0.7 and 1.7±1.0), azurophils (1.9±1.0 and 1.9±0.8), heterophils (0.8±0.9 and 0.6±0.4), and basophils (0.4±0.2 and 0.4±0.3). There were no significant differences in hematological parameters between the two species of snakes. Some hematological changes observed in both species are probably associated with factors that influence their physio- logical state such as stress of capture, seasonality, and diet among others. Intracellular parasites were not found in any of the specimens studied. These hematological results provide a reference range for adult snakes in the two species and are similar to those of previously studied snake species fromother groups.