Background Current digital cell imaging systems perform peripheral blood smear (PBS) analysis in limited regions of the PBS and require the support of manual microscopy without achieving full digital microscopy. We report a multicenter study that validated the Scopio Labs X100 Full Field PBS, a novel digital imaging system that utilizes a full field view approach for cell recognition and classification, in a decision support system mode. Methods We analyzed 335 normal and 310 abnormal PBS from patients with various clinical conditions and compared the performance of Scopio's Full Field PBS as the test method, with manual PBS analysis as the reference method. Deming regression analysis was utilized for comparisons of WBC and platelet estimates. Measurements of WBC and platelet estimation accuracy along with the agreement on RBC morphology evaluation were performed. Reproducibility and repeatability (R&R) of the system were also evaluated. Results Scopio's Full Field PBS WBC accuracy was evaluated with an efficiency of 96.29%, sensitivity of 87.86%, and specificity of 97.62%. The agreement between the test and reference method for RBC morphology reached 99.77%, and the accuracy for platelet estimation resulted in an efficiency of 94.89%, sensitivity of 90.00%, and specificity of 96.28%, with successful R&R tests. The system enabled a comprehensive review of full field PBS as shown in representative samples. Conclusions Scopio's Full Field PBS showed a high degree of correlation of all tested parameters with manual microscopy. The novel full field view of specimens facilitates the long‐expected disengagement between the digital application and the manual microscope.
Background COVID-19 infection is associated with a hypercoagulable state. Severe COVID-19 patients present with high plasma fibrinogen levels, continuous deposition of fibrin and the presence of microthrombi in their lungs, accompanied by significant fibrinolysis, resulting in high D-dimer levels. Due to the role of FXIII in fibrin crosslinking and clot stabilization, we analyzed its activity levels and dynamics in COVID-19 patients hospitalized in the intensive care unit (ICU). Methods FXIII levels were measured in thirty four COVID-19 patients hospitalized in the ICU and in fourteen non-severe COVID-19 patients. FVIII levels were measured for comparison. Laboratory data and clinical variables were recorded. Results The average FXIII activity level in 34 ICU hospitalized COVID-19 patients was 69.9±33 %, significantly lower compared to an average of 120±20.9 % FXIII activity in 14 non-severe COVID-19 patients. FXIII activity levels were below the low normal value (< 79 % FXIII activity) in 74 % of the ICU hospitalized COVID-19 patients. In contrast, high FVIII activity was measured among all severe COVID-19 patients. Consecutive measurements, performed in fourteen ICU hospitalized COVID-19 patients, pointed to a significant decrease in FXIII activity from the average of 85.7±28.2 %, (which is in the normal range), to an average of 68.0±20.4 %, below the low normal range, within 6.4±3.4 days of ICU hospitalization. Liver functions did not differentiate between patients with low and normal FXIII activity. No inhibitor to FXIII activity was found in the plasma of severe COVID-19 patients. Levels of FXIII-A antigen correlated with FXIII activity, and were low in severe COVID-19 patients. Conclusions Low FXIII activity levels were found in COVID-19 patients hospitalized in the ICU, with gradual decline during their hospitalization. A mechanism of consumption may account for the low FXIII activity in these patients.
Background The demand for morphological diagnosis by peripheral blood smear (PBS) analysis with clearly defined turnaround times (TAT), coupled with a shortage of morphologists and increasing cost containment, is driving digitalization to the forefront of laboratory workflow. Labor-intensive manual PBS review affects weekend workflow with limited staff availability. The impact of remote analysis of PBS on the performance of hematology laboratories has not yet been assessed. Objectives Following implementation of fully remote digital microscopy within our laboratory, we measured its impact on morphology workflow efficiency, TAT and hours saved per month. Methods A retrospective study of the effects of remote PBS analysis on the morphology workflow in a tertiary medical center using the Scopio Labs X100 Full-Field PBS system was conducted. 10,704 PBS samples were analyzed pre-and post –implementation, over a five-month period. Overall PBS workload, and average TAT of PBS samples over weekends and the first two weekdays were collected and evaluated. Results Remote weekend viewing resulted in a 15.8% reduction in the overall morphology TAT of the lab (P<0.03) over a five-month period, despite similar overall workload. PBS analysis TAT on Fridays was reduced by 41.4% (P <0. 006), and by 59.1% on the first weekday (P<0.02). The additional hours incurred over the weekend were offset against a reduced need for double weekday shifts resulting in approximately 12.76 work hours saved per month. Internet links to clinically relevant cases are provided. Conclusions The Scopio Labs Full-Field X100 PBS system with remote analysis capacity significantly reduced PBS TAT and improved the morphology workflow of the hematology laboratory. PBSs with significant clinical findings are now available for remote viewing by on-call clinicians located outside the medical center perimeter. Remote PBS viewing, coupled with the overall monthly cost savings, merit consideration for the implementation of full digitalization for remote PBS review.
This paper describes two cases of toxoplasmic chorioretinitis presenting in two French soldiers who had been receiving oral doxycycline for malaria prophylaxis. This is despite the proven effectiveness of oral doxycycline in treating , the most common cause of this infection. The lack of effectiveness of oral doxycycline in these two cases most likely reflected that the ocular concentration of 100 mg daily doxycycline is too low to treat or prevent Toxoplasmic retinochoroiditis (TC). Clinicians should therefore be aware that soldiers taking prophylactic oral doxycycline are still at risk of developing ocular TC with potentially sight-threatening consequences if not treated adequately.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.