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Srinivasan P.,New York Hospital Queens | Brandler M.,New York Hospital Queens | D'Souza A.,SUNY Downstate Medical Center | Millman P.,New York Hospital Queens | Moreau H.,Physicians Regional Medical Center
Journal of Perinatology | Year: 2010

An uncommon clinical entity mimicking necrotizing enterocolitis (NEC) is allergic enterocolitis secondary to cow's milk protein allergy. Although milk protein allergy is the most common food allergy among infants and young children, the incidence and prevalence of this disease entity presenting as enterocolitis in neonates is not well documented. We report this case of milk protein-associated allergic enterocolitis to highlight the unusual recurrent presentation as NEC, (with recurrent pneumatosis, bloody stools) managed successfully with modification of milk formula. © 2010 Nature Publishing Group All rights reserved. Source

Rekkerth D.J.,Greer Laboratories Inc. | Hadley J.A.,Physicians Regional Medical Center
Allergy, Asthma and Clinical Immunology | Year: 2014

Background: Skin prick/puncture testing (SPT) is widely accepted as a safe, dependable, convenient, and cost-effective procedure to detect allergen-specific IgE sensitivity. It is, however, prone to influence by a variety of factors that may significantly alter test outcomes, affect the accuracy of diagnosis, and the effectiveness of subsequent immunotherapy regimens. Proficiency in SPT administration is a key variable that can be routinely measured and documented to improve the predictive value of allergy skin testing. Methods: Literature surveys were conducted to determine the adherence to repeated calls for development and implementation of proficiency testing standards in the 1990's, the mid-2000's and the 2008 allergy diagnostics practice parameters. Results: Authors publishing clinical research in peer-reviewed journals and conducting workshops at annual scientific meetings have recommended proficiency testing based primarily on its potential to reduce variability, minimize confounding test results, and promote more effective immunotherapeutic treatments. Very few publications of clinical studies, however, appear to report proficiency testing data for SPT performance. Allergen immunotherapy recommendations are updated periodically by the Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), and the Joint Council of Allergy, Asthma and Immunology (JCAAI). Conclusions: Despite consensus that all staff who perform SPT should meet basic quality assurance standards that demonstrate their SPT proficiency, the gap between recommendations and daily practice persists. By embracing standards, the accuracy of SPT and allergy diagnosis can be optimized, ultimately benefiting patients with allergic disease. © 2014 Fatteh et al. Source

Gulati G.L.,Thomas Jefferson University | Bourne S.,Thomas Jefferson University | Bourne S.,Physicians Regional Medical Center | Jamal S.M.E.,Thomas Jefferson University | And 2 more authors.
Laboratory Medicine | Year: 2011

Objective: This study was undertaken to determine if automated differential leukocyte counts (A-DIFF) can be used in place of manual differential leukocyte counts (M-DIFF) in chronic lymphocytic leukemia (CLL) patients. Methods: Relative and absolute automated lymphocyte counts obtained from 83 specimens from 76 CLL patients were compared with corresponding manual counts obtained by performing differential on albuminized blood smears. Means and correlation coefficients were calculated using Excel software. Results: The mean relative lymphocyte count by automated method was 73.6% as compared to 75.6% by the manual method. The mean absolute lymphocyte count by automated method was 32.1 × 10 3/μL as opposed to 32.9 × 10 3/μL by the manual method. The correlation coefficients were 0.928 and 0.998 for the relative lymphocyte counts and absolute lymphocyte counts, respectively. Conclusion: Automated differential leukocyte counts can be used in place of M-DIFF in CLL. Source

Bowyer H.R.,University of Pittsburgh | Glover M.,Physicians Regional Medical Center
Journal of Neuroscience Nursing | Year: 2010

Guillain-Barre syndrome (GBS) is a syndrome that affects the immune system and attacks the peripheral nervous system. Discussion includes defining GBS as well as its etiology and differential diagnosis. Patients with GBS are not uncommon, and therefore it is important to be educated and to have a more precise understanding. GBS patients need to be treated holistically through emotional and physical support and known effective treatments. Through this article, readers will be able to achieve a thorough understanding of GBS and management options/strategies. Clinical features and manifestation of presenting symptoms will assist in determining initial laboratory studies, imaging, and any other testing that should be performed. Proper and quick diagnosis of GBS will be critical to further optimize treatment options and to decrease the likelihood of further immediate progression. Treatment modalities will be discussed as well as management during the acute hospital course and after discharge from the acute care facility. Discussion will focus on moderate to severe cases and associating treatment plans evaluated from evidence-based practice. Copyright © 2010 American Association of Neuroscience Nurses. Source

Bourne S.,Thomas Jefferson University | Bourne S.,Physicians Regional Medical Center | Ma N.,Thomas Jefferson University | Ma N.,Medical Center | And 3 more authors.
Laboratory Medicine | Year: 2013

Objective: Immature granulocyte (IG) count is the latest addition to the automated leukocyte differential generated by the Sysmex analyzers. The objective of this study was to assess the reliability of the automated IG counts. Methods: Automated IG percentages were compared with the corresponding manual IG percentages of 418 blood specimens. The data were divided into five groups. The difference between individual automated IG percentages and corresponding manual IG percentages was plotted and the number of outliers, based on Rumke's published 95% confidence limits, was determined for each group. Results: Of 418 automated IG percentages, 392 were within 95% confidence limits, with 26 outliers. More than half of the outliers carried also the "blast" flag, prompting a smear review. A significant difference between manual and automated IG percentage was noted when the manual IG count was greater than 10%. Conclusion: Automated and manual IG percentages compared fairly well with each other. We concluded that automated IG counts less than or equal to 10% may be considered reportable without a smear review. Source

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