Routine Hematology (2)

Routine Hematology

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Summary: Routine Hematology provides testing for CBC and differentials, urinalysis, routine coagulation, and body fluid cell counts and differentials.

The hematology section of the Department of Pathology at the Madigan Army Medical Center performs tests in routine hematology, coagulation, urinalysis, body fluid analysis, flow cytometry, and special stains for bone marrows, body fluids, and tissue. The hematology section comprised of 8 civilian medical technologists, and 8 military medical laboratory technicians.

The mission of the hematology section is to provide quality patient care through giving accurate results of all the tests performed in the hematology section. Continuous quality improvement is a major factor in the mission of the section. Important process are monitored and evaluated for opportunities to enhance the quality and timeliness of the patient care provided. Education, through training and mentoring, is strongly emphasized to fulfill the mission of the section. The dedicated professionals in the Hematology section offer quality and competence to serve patients at Madigan Army Medical Center.

A complete range of tests is available with high-tech automated equipment and procedures in all disciplines. Some of the main tests offered by Hematology sections are the following:

o Complete Blood Count (CBC)
o Reticulocyte Count
o Manual Differential
o Body Fluid Cell Counts and Morphology
o Urinalysis with Microscopic Exam
o Prothrombin Time (PT)
o Activated Partial Thromboplastin Time (APTT)
o Mixing Studies
o Fibrinogen
o Quantitative D-Dimer
o Fibrin Split products (FSP)
o Complete Semen Analysis
o Flow Cytometry – Lymphocyte subsets and panels
o G-6-PD
o Sickle Cell
o Hgb Electrophoresis
o Factor Assays
o APCR
o Lupus Anticoagulant

The specimen containers in hematology section have lavender-top EDTA vacutainer which is properly filled and will be perfect for the CBC, ESR, and Reticulocyte count. The light blue-top sodium citrate tubes which are completely full, maximum draw will be enough for PPT, Fibrinogen, D-dimer, Fibrin split products, and mixing studies. All the tubes for the specimen must be properly filled and well-mixed to be acceptable. Dilution of blood by the appropriate anticoagulant is critical in order to get a precise result and all specimens which do not meet department standards for identification will be rejected.

Routine Hematology involves the following:

o Complete Blood Count (CBC) which consist of the following tests: WBC, RBC, HGB, MCV, MCH, MCHC, RDW, PLT, MPV, and automated differential which includes percentage and absolute number of cell types.
o A manual differential is performed only if designated laboratory criteria are met
o All peripheral smears are kept for one month
o Many tests are time dependent after collection. Routine Hematology tests that require testing in a specific time period are:
* ESR- within 8 hours of collection
* CBC- within 24 hours of collection
* Differntial- within 8 hours of collection
* PT/PTT- within 4 hours of collection
* Fibrinogen- within 4 hours of collection
* Urinalysis- within 2 hours of collection or refrigerate

Possible Heart Risks Due To Long-Term Pill Use

Possible Heart Risks Due To Long-Term Pill Use


Over the years, about 100 million women worldwide are taking oral contraceptives with high estrogen content.
Most of these pills, which were first sold in 1960, combine synthetic estrogen and progestin in various doses and are known to carry a small risk of blood clots and high blood pressure.

One small study from Belgium suggests that long-term use of oral contraceptives might increase the chances of having artery build-ups that can raise the risk of heart disease. Although the study needs further rigorous testing, it’s importance can never be undermined due to the great number of women that are now taking the pill.

However, Dr. JoAnn Manson, chief of preventive medicine at Harvard-affiliated Brigham and Women’s Hospital in Boston thinks that this theory should not cause any alarm among women. And while she had no role in the new study, which was presented Tuesday at an American Heart Association conference in Florida, she cited that many previous studies have found no large increase in heart attacks among pill users. Manson added that since they are already known to carry a small risk of blood clots and high blood pressure for women currently taking them, and any additional heart attack or stroke risk is thought to be related to those two effects.

In a long-running observational study in the small town of Erpe-Mere, researchers at the University of Ghent in Belgium studied about 1,300 healthy women ages 35 to 55 to look for other signs of heart risks among past and current pill users. According to Dr. Ernst Rietzschel, the study’s chief researcher, about 81 percent had taken oral contraceptives for more than a year at some point in their lives. The results of the Belgian study ran very close to the findings of the U.S. Centers for Disease Control and Prevention that undertook a similar study on American women ages 15 to 44.

Ultrasound exams were done of arteries in their necks and legs to look for buildups called plaque. There was a 20 to 30 percent increased prevalence of plaque for every 10 years of oral contraceptive use. While the plaques may be small enough not to block an an artery, any plaque is thought to raise the risk of heart disease. However, researchers admitted that they have no information on whether the presence of plaque translated to any true risk of heart attacks or strokes in the group.

Several women in the study had taken first-generation birth control pills, which had twice the estrogen levels compared with those sold in pharmacies today. And though the doses and length of continuous pill use matters a lot in terms of impact assessment, the Belgian researchers do not have enough detail or facts from which to base a definitive medical analysis, said Dr. Daniel Jones, a University of Mississippi cardiologist and president of the Heart Association.

“It could be an important study,” said Jones, which needs to be tested in larger and more rigorous studies wherein one group of women are given pills, another are not, and their health is closely watched for some time afterward.

Rietzschel assures women who are worried about heart risks that there is no need to abandon birth control pills but should follow guidelines for their use and avoid other things that raise heart risks, like smoking, being overweight, and lack of exercise.