Prognostic value of platelet indices as determined by ADVIA 120 in patients suspected of having disseminated intravascular coagulation

Recent technological advances have made it possible to record a variety of platelet indices using automated hematology analyzers. Disseminated intravascular coagulation (DIC) is associated with the dramatic hemostasis activation, with evidence of fibrin formation and platelet consumption. We investigated the prognostic significance of platelet indices as measured by ADVIA in 222 patients suspected of having DIC. The presence of overt DIC was defined using the scoring system of the International Society of Thrombosis and Haemostasis Subcommittee. Twenty-eight day hospital mortality was used as a clinical prognosis parameter. Median platelet count and platelet-crit (PCT) levels markedly decreased in nonsurvivors, whereas mean platelet volume (MPV), platelet component distribution width (PCDW) and platelet dry mass distribution width (PMDW) were significantly increased in nonsurvivors. In terms of ROC analysis, which was conducted to predict 28-day mortality, areas under the receiver operating characteristic curve (AUC) were; 0.73 platelet count, 0.72 for PCT, 0.69 for PCDW, 0.65 for PMDW and 0.61 for MPV. The odds ratio of a reduced platelet count for the relative risk of 28-day mortality was 5.249 (95% CI: 2.399-11.486), and the odds ratio for PCDW was 3.240 and for PMDW 3.262. Among these indices, platelet count, PCDW and PMDW were found to be more predictive of 28-day hospital mortality. Our results suggest that these indices may provide prognostic information on hospital mortality in the patients suspected of having DIC.     

西门子ADVIA Workcell自动化系统自动检验流水线简介

实验室自动化系统又称全实验室自动化,是指为了实现临床实验室中的几个检测系统如临床化学、免疫学、血液学等的整合,将不同的分析仪器与分析前和分析后的实验室分析系统通过自动化传输轨道串联起来,在信息化网络的主导控制下,构成流水线作业的组合,达到流程最优化,效率最大化的目的。     

The determination of a reference range for new platelet parameters produced by the Bayer ADVIATM120 full blood count analyser

Summary One hundred and twenty‐two samples from normal volunteers were processed for full blood count analysis through the Bayer ADVIA^TM120. The samples were simultaneously tested using the marker CD62P to establish the absence of platelet activation. Samples were tested at two time intervals, 20 min and 3.5 h, to simulate the testing practice for routine and urgent samples in our laboratory. From these data the mean and reference ranges, with 95% confidence limits, for platelet parameters were calculated for the ADVIA^TM120. The time difference for some platelet parameters was significant. Hence two ranges have been reported. The age or smoking habit of the volunteer did not significantly affect platelet results but there was a statistically significant sex difference in some platelet parameters.     

血小板参数MPC、MPM、L-PLT等在冠心病诊断中的应用

目的探讨血小板新型参数——平均血小板内容物浓度(MPC)、平均血小板内容物含量(MPM)、大血小板(L-PLT)等在(CHD)患者中的变化及其临床意义。方法根据CHD的诊断标准及冠状动脉造影结果,选取CHD患者92例和正常对照98名,采用德国Bayer公司生产的ADVIA120血液分析仪测定血小板新型参数MPC、MPM、L-PLT及原有血小板参数血小板数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW),并用统计学方法(t检验)对其数据进行分析。结果CHD患者血中PLT明显低于正常对照组(P<0.01),而MPV、PDW均明显高于正常对照组(P<0.05),且MPC、MPM、L-PLT均明显高于正常对照组(P<0.05)。结论血小板新型参数MPC、MPM、L-PLT联合血小板原有参数PLT、MPV、PDW在辅助诊断CHD中有一定的临床价值。     

ADVIA2120全自动血球分析系统HGB、RBC及WBC线性范围的测定与评价

目的测定并分析Bayer ADVIA 2120全自动血细胞分析系统HGB、RBC、WBC线性范围,以评价该检测方法的性能。方法以健康人混合抗凝全血制备高值样本,高值样本WBC及RBC赋值采用细胞计数法,HGB赋值采用氰化高铁血红蛋白法,高值样本用同型非溶血血浆稀释,在校准后的血细胞分析系统上依低高及高低顺序分别行3次测定,以预期值与实测值做直线相关与回归分析。结果HGB线性范围为0—280g／L,相关系数γ=0．998,单侧t检验P〈0．005;RBC线性范围为0—7．99×10^12／L,相关系数γ=0．994,P〈0．001;WBC线性范围为0—521．3×10^9／L,相关系数γ=0．985,P〈0．05。结论结论本系统HGB、RBC、WBC线性区间评估值比该仪器生产厂家自测值略宽,提示上述项目的可报告范围应宽于厂家设定的范围。     

Comparison of ADVIA Centaur® and Pharmacia UniCAP® tests in the diagnosis of food allergy in children with atopic dermatitis

In a study comprising 63 children diagnosed with atopic dermatitis, the results of the ADVIA Centaur system was compared with the results obtained with the Pharmacia UniCAP100 system, which has been widely considered as a reference method for seric specific IgE (sIgE) measurements. The individual immunization against the most common food allergens [egg (f1), cow milk (f2), cod (f3), wheat (f4), peanut (f13) and soy bean (f14)] was determined by in vitro serum IgE testing and skin prick test (SPT). The comparison of the sIgE titers revealed a good concordance between the Centaur and the UniCAP tests for f1, f3, and f13 (94 %, 91 %, and 96 % respectively). However, the concordance was lower for f2, f4, and f14 (76 %, 77 %, and 77 % respectively) because of discrepancies between the two techniques. When compared with SPT and clinical diagnosis, on the 40 discordant cases found between the Centaur and the UniCAP, the Centaur showed concordance with the patients food reaction and SPT in 34/40 cases, and UniCAP in only 6/40 cases. Accordingly, the Centaur test displayed a statistically significantly better performance on specificity and concordance with SPT for f2, f4, and f14 (concordance/specificity = 70%/71%, 76%/75% and 90%/88% respectively), than the CAP test (49%/54%, 51%/52% and 67%/65% respectively).     

Racial and ethnic disparities in the management of acute pain in US emergency departments: Meta-analysis and systematic review

ObjectiveThis review aims to quantify the effect of minority status on analgesia use for acute pain management in US Emergency Department (ED) settings.MethodsWe used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology to perform a review of studies from 1990 to 2018 comparing racial and ethnic differences in the administration of analgesia for acute pain. Studies were included if they measured analgesia use in white patients compared to a racial minority in the ED and studies were excluded if they focused primarily on chronic pain, case reports and survey studies. Following data abstraction, a meta-analysis was performed using fixed and random-effect models to determine primary outcome of analgesia administration stratified by racial and ethnic classification.Results763 articles were screened for eligibility and fourteen studies met inclusion criteria for qualitative synthesis. The total study population included 7070 non-Hispanic White patients, 1538 Hispanic, 3125 Black, and 50.3% female. Black patients were less likely than white to receive analgesia for acute pain: OR 0.60 [95%-CI, 0.43–0.83, random effects model]. Hispanics were also less likely to receive analgesia: OR 0.75 [95%-CI, 0.52–1.09].ConclusionThis study demonstrates the presence of racial disparities in analgesia use for the management of acute pain in US EDs. Further research is needed to examine patient reported outcomes in addition to the presence of disparities in other groups besides Black and Hispanic. Trial registration: Registration number CRD42018104697 in PROSPERO.