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Synovial fluid is a viscous liquid found in the cavities of synovial joints. Several articular diseases are characterised by fluid accumulation in joints, so that arthrocentesis and morphological analysis are essential tools for differentiating a non-inflammatory arthropathy from an inflammatory arthropathy or an infectious disease. Cell count and differentiation are important diagnostic aspects in such patients. This first SEED article about synovial fluid summarises the typical characteristics and recommends procedures for specimen collection and handling.
To interpret the result of a blood count, a physician needs reference intervals from healthy people alongside the results of the analysis. The challenge is to define a ’healthy’ reference cohort. Common diseases with a long latency period, such as anaemia, are not recognised by individuals and therefore cannot be determined via questionnaires. The LAVE approach, explained in detail in the SEED, offers the possibility to exclude exactly these individuals from the reference cohort. The SEED lists reference intervals for adults for 105 parameters of XN-Series analysers based on a Dutch cohort.
The term ‘NRBC’ – ‘nucleated red blood cells’ – refers to precursor cells of the red blood cell lineage which still contain a nucleus. In healthy adults and older children, NRBC can only be found in blood-building bone marrow where they mature. Their appearance in peripheral blood points to extramedullary erythropoiesis or disruption of the blood - bone marrow barrier. Both possible scenarios can only be found in the course of a severe disease.
Direct detection of blood doping is relatively time-consuming and cost intensive. Some of the banned substances, such as recombinant human erythropoietin (rhEPO), can hardly be distinguished from natural, endogenous hormones. This SEED describes how it is nevertheless possible to indirectly detect EPO-like doping with a modern haematology analyser like the XN-Series and reticulocyte parameters. The World Anti-Doping Agency (WADA) has played a leading role in the development of the Athlete Biological Passport for monitoring blood parameters such as RET#, RET%, HGB or HCT to ensure fairness among athletes.
Thrombocytopenia is a disorder in which there is an abnormally low amount of platelets. It can be life threatening and its detection and precise count is extremely important. The immature platelet fraction (IPF parameter) measures young, reticulated platelets in peripheral Blood, revealing if the bone marrow is producing or not.