DOCSLIB.ORG

Sarah Barns Thesis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sarah Barns Thesis NUMERICAL MODELLING OF RED BLOOD CELL MORPHOLOGY AND DEFORMABILITY SARAH BARNS BEng(Mech)(Hons), GradCert(TerEd), GradDip(Math) Submitted in fulfilment for the requirements of the degree DOCTOR OF PHILOSOPHY School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology in collaboration with The Australian Red Cross Blood Service, Brisbane, Queensland, Australia 2018 Statement of Originality The work contained in this thesis has not been previously submitted to meet requirements for an award at this or any other higher education institution. To the best of my knowledge and belief, the thesis contains no material previously published or written by another person except where due reference is made. Signature: QUT Verified Signature Date: July 28, 2018 Numerical Modelling of Red Blood Cell Morphology and Deformability Page i Keywords . Red blood cell . Numerical modelling . Course-grained particle method . Morphology . Shape . Deformability . Discocyte . Echinocyte . AFM indentation . Optical tweezer stretching . Membrane . Mechanics . Hertz contact . Mechanical deformation Page ii Numerical Modelling of Red Blood Cell Morphology and Deformability Abstract The primary function of the red blood cell (RBC) is to distribute oxygen throughout the body. This requires RBCs to squeeze through narrow blood vessels which can be just half their own diameter, making cellular deformability critical for performance. RBC deformability is predominately controlled by the properties of the cell membrane, which consists of an outer lipid bilayer with embedded proteins and cholesterol, and a spectrin-based cytoskeleton tethered beneath. The strength of the bilayer’s resistance to bending and surface area changes, as well as the strength of the cytoskeleton’s resistance to stretch and shear dictate the cell’s ability to deform under external loading. Changes within the RBC membrane’s physical structure can reduce deformability, making the cells less efficient at moving through the body. This occurs naturally as RBCs age, but is accelerated during the storage of RBCs prior to transfusion, and also during the progression of diseases such as malaria. Although changes within the RBC membrane are well-accepted as the basis of deformability loss, the specifics of the underlying mechanisms remain unclear. Furthermore, given deformability differences can be detected experimentally, measuring RBC deformability in various experimental setups has been proposed as a potential tool for quantifying the quality of RBC units prior to transfusion and for the diagnosis of disease. Underlying structural changes of the RBC membrane can be explored with numerical models, which allow investigation of the mechanical aspects that define RBC behaviour at a much smaller scale than is possible with experimentation, which becomes challenging and costly. Deeper insight into how the mechanical state of the membrane contributes to physical changes in RBCs will aid in developing new strategies for improving RBC storage, potentially leading to higher quality RBCs for transfusion and longer maximum storage durations. It may also contribute to understanding the mechanical basis of RBC conditions. Therefore, the impact of mechanical changes within the RBC membrane on deformability was investigated using the coarse-grained particle method (CGPM). Secondly, deformability measurements in indentation and stretching setups were explored to understand their potential for detecting differences in mechanical properties of the membrane. Numerical Modelling of Red Blood Cell Morphology and Deformability Page iii As a first step of this study, the typical RBC discocyte resting shape was predicted in both 2D and 3D and validated against experimental observations from the literature. The models were then adapted to investigate the behaviour of RBCs when placed under a local compressive force to simulate indentation with atomic force microscopy (AFM), as well as when a global tensile force was applied to the cell, modelling stretching within an optical tweezer setup. Indentation investigations revealed that changes to the membrane’s bending stiffness had the most dominant impact on deformability in this loading scenario. As bending stiffness is mainly provided by the bilayer, AFM indentation would be well- suited to detecting physical changes within this part of the RBC membrane. Force- deformation curves from RBC indentation have been historically analysed using Hertzian contact theory to extract Young’s modulus for the membrane. However numerical investigations showed that this method of analysis was extremely limited in its application to RBC indentation problems due to difficulties justifying underlying assumptions of solid contact and negligible substrate influence. Furthermore, Young’s modulus predictions were highly sensitive to the region of the cell indented and the degree of adhesion, meaning that the deformability of both the cell and substrate were being measured rather than the membrane in isolation. Therefore an alternative method of analysis is required to reconcile the comparison of measurements between different AFM setups to further mature this technique. The stretching investigations showed that changes to the membrane’s linear stiffness had the most dominant impact on deformability in this loading scenario. Given that linear stiffness of the membrane is mainly associated with the spectrin- based cytoskeleton, the optical tweezer setup would be well-suited to detecting changes to cytoskeletal mechanical properties. To inform experimental design, it was found that optical bead size had little impact on deformability measurements, while the degree of adhesion did have a significant impact. As a final step in this study, the capacity to predict the discocyte-echinocyte resting shape sequence was explored. This found that impacting the spontaneous curvature for local regions gave rise to the development of echinocyte morphologies. This established a baseline direction for testing echinocyte morphologies in deformability scenarios in the future when experimental data becomes available. The CGPM models developed in this project have been shown effective in predicting the physical behaviour of RBCs under local compressive and global Page iv Numerical Modelling of Red Blood Cell Morphology and Deformability tensile loading. They may then form the basis of future work informing the design of devices and data analysis techniques for quantifying the deformability of RBC units prior to transfusion or for the diagnosis of disease. However, as the current methodology relies on the stiffness coefficients being tailored to the specific application, improved optimisation for the stiffness coefficients and greater sophistication in the energy equations should be considered. Resolving the lack of universality of the model should enable improved performance and predictive power going forward. Numerical Modelling of Red Blood Cell Morphology and Deformability Page v Acknowledgements I would like to thank my partner Laurie for supporting me through this PhD, including the sacrifices associated with commuting between Brisbane and Melbourne for the first two years. I would also like to thank my family and friends for their ongoing support. Furthermore, special thanks to the friends who have been on the research pathway alongside me, particularly Ted Pickering, Marie Anne Balanant, Ari Bo and Chris From. I would like to thank my supervisory team of YuanTong Gu, Emilie Sauret and Robert Flower. I appreciate YuanTong allowing me the time and space to pursue my teaching ambitions, Emilie for being an ever-reliable source of advice and direction, and Robert for welcoming me into the Blood Service community. I would also like to extend thanks to the wider Blood Service Research & Development Team, and in particular Helen Faddy who was instrumental in providing feedback through the last few months in preparing this document. I would like to thank the undergraduate students who have worked on this project across both final year projects and the vacation research experience scheme. Finally, I would also like to acknowledge the top-up scholarship I received from the Alexander Steele Young Lions Memorial Foundation which eased the financial pressures of pursuing a PhD over the last three years. Page vi Numerical Modelling of Red Blood Cell Morphology and Deformability List of Publications Peer-Reviewed Journal Articles: . S. Barns, M. A. Balanant, E. Sauret, R. Flower, S. Saha, and Y. Gu, "Investigation of red blood cell mechanical properties using AFM indentation and coarse-grained particle method," BioMedical Engineering OnLine, vol. 16, pp. 1-21, 2017. Available from: http://doi.org/10.1186/s12938-017-0429-5 . S. Barns, E. Sauret, S. Saha, R. Flower, and Y. Gu, "Two-Layer Red Blood Cell Membrane Model using the Discrete Element Method," Applied Mechanics and Materials, vol. 846, pp. 270-275, 2016. Available from: http://doi.org/10.4028/www.scientific.net/AMM.846.270 Extended Conference Abstract: . M. A. Balanant, S. Barns, E. Sauret, and Y. T. Gu, "Investigation of Red Blood Cell Membrane Elasticity using AFM Indentation and the Coarse- Grained Particle Method," in 10th Australasian Biomechanics Conference, Melbourne, Australia, 2016. Poster Presentation: . S. Barns, E. Sauret, R. Flower, and Y.T. Gu, “Numerical Investigation of Red Blood Cell Membrane Mechanical Properties on Deformability during Indentation,” in 27th Regional Congress of
Load more

Recommended publications
  • Modelling of Red Blood Cell Morphological and Deformability Changes During In-Vitro Storage
    applied sciences Article Modelling of Red Blood Cell Morphological and Deformability Changes during In-Vitro Storage Nadeeshani Geekiyanage 1 , Emilie Sauret 1,*, Suvash Saha 2 , Robert Flower 3 and YuanTong Gu 1 1 School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane City, QLD 4000, Australia; [email protected] (N.G.); [email protected] (Y.G.) 2 School of Mechanical and Mechatronic Engineering, University of Technology Sydney (UTS), Ultimo, NSW 2007, Australia; [email protected] 3 Research and Development, Australian Red Cross Lifeblood, Kelvin Grove, QLD 4059, Australia; [email protected] * Correspondence: [email protected] Received: 28 February 2020; Accepted: 27 April 2020; Published: 4 May 2020 Featured Application: Red blood cell (RBC) storage lesion is a critical issue facing transfusion treatments, and significant changes in RBC morphology and deformability are observed due to the storage lesion. RBCs require high deformability to sustain in-vivo circulation, and impaired deformability leads to several post-transfusion adverse outcomes. Therefore, improved understanding of the interrelation between the morphological and deformability changes and the quality and viability of the stored RBCs is essential to prevent or reduce the transfusion related adverse outcomes. To support this requisite, the influence on RBC deformability due to several aspects of the storage lesion, namely, the changes in cell morphology, surface area and volume, RBC membrane biomechanics, and cytoskeletal structural integrity are explored numerically in this study. Abstract: Storage lesion is a critical issue facing transfusion treatments, and it adversely affects the quality and viability of stored red blood cells (RBCs).
    [Show full text]
  • Morphological Study of Human Blood for Different Diseases
    Research Article ISSN: 2574 -1241 DOI: 10.26717/BJSTR.2020.30.004893 Morphological Study of Human Blood for Different Diseases Muzafar Shah1*, Haseena1, Kainat1, Noor Shaba1, Sania1, Sadia1, Akhtar Rasool2, Fazal Akbar2 and Muhammad Israr3 1Centre for Animal Sciences & Fisheries, University of Swat, Pakistan 2Centre for Biotechnology and Microbiology, University of Swat, Pakistan 3Department of Forensic Sciences, University of Swat, Pakistan *Corresponding author: Muzafar Shah, Centre for Animal Sciences & Fisheries, University of Swat, Pakistan ARTICLE INFO ABSTRACT Received: August 25, 2020 The aim of our study was the screening of blood cells on the basis of morphology for different diseased with Morphogenetic characters I e. ear lobe attachment, clinodactyly Published: September 07, 2020 and tongue rolling. For this purpose, 318 blood samples were collected randomly. Samples were examined under the compound microscopic by using 100x with standard Citation: Muzafar Shah, Haseena, method. The results show 63 samples were found normal while in 255 samples, different Kainat, Noor Shaba, Sania, Sadia, et al. types of morphological changes were observed which was 68.5%, in which Bite cell 36%, Morphological Study of Human Blood for Elliptocyte 34%, Tear drop cell 30%, Schistocyte 26%, Hypochromic cell 22.5%, Irregular Different Diseases. Biomed J Sci & Tech Res contracted cell 16%, Echinocytes 15.5%, Roleaux 8%, Boat shape 6.5%, Sickle cell 5%, Keratocyte 4% and Acanthocytes 1.5%. During the screening of slides, bite cell, elliptocyte, tear drop cell, schistocytes, hypochromic cell, irregular contracted cells were found 30(1)-2020.Keywords: BJSTR.Human MS.ID.004893. blood; Diseases; frequently while echinocytes, boat shape cell, acanthocytes, sickle cells and keratocytes Morphological; Acanthocytes; Keratocyte were found rarely.
    [Show full text]
  • Complete Blood Count in Primary Care
    Complete Blood Count in Primary Care bpac nz better medicine Editorial Team bpacnz Tony Fraser 10 George Street Professor Murray Tilyard PO Box 6032, Dunedin Clinical Advisory Group phone 03 477 5418 Dr Dave Colquhoun Michele Cray free fax 0800 bpac nz Dr Rosemary Ikram www.bpac.org.nz Dr Peter Jensen Dr Cam Kyle Dr Chris Leathart Dr Lynn McBain Associate Professor Jim Reid Dr David Reith Professor Murray Tilyard Programme Development Team Noni Allison Rachael Clarke Rebecca Didham Terry Ehau Peter Ellison Dr Malcolm Kendall-Smith Dr Anne Marie Tangney Dr Trevor Walker Dr Sharyn Willis Dave Woods Report Development Team Justine Broadley Todd Gillies Lana Johnson Web Gordon Smith Design Michael Crawford Management and Administration Kaye Baldwin Tony Fraser Kyla Letman Professor Murray Tilyard Distribution Zane Lindon Lyn Thomlinson Colleen Witchall All information is intended for use by competent health care professionals and should be utilised in conjunction with © May 2008 pertinent clinical data. Contents Key points/purpose 2 Introduction 2 Background ▪ Haematopoiesis - Cell development 3 ▪ Limitations of reference ranges for the CBC 4 ▪ Borderline abnormal results must be interpreted in clinical context 4 ▪ History and clinical examination 4 White Cells ▪ Neutrophils 5 ▪ Lymphocytes 9 ▪ Monocytes 11 ▪ Basophils 12 ▪ Eosinophils 12 ▪ Platelets 13 Haemoglobin and red cell indices ▪ Low haemoglobin 15 ▪ Microcytic anaemia 15 ▪ Normocytic anaemia 16 ▪ Macrocytic anaemia 17 ▪ High haemoglobin 17 ▪ Other red cell indices 18 Summary Table 19 Glossary 20 This resource is a consensus document, developed with haematology and general practice input. We would like to thank: Dr Liam Fernyhough, Haematologist, Canterbury Health Laboratories Dr Chris Leathart, GP, Christchurch Dr Edward Theakston, Haematologist, Diagnostic Medlab Ltd We would like to acknowledge their advice, expertise and valuable feedback on this document.
    [Show full text]
  • The Influence of Magnetic Fields on Selected Physiological Parameters
    bioRxiv preprint doi: https://doi.org/10.1101/497990; this version posted December 17, 2018. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. 1 The Influence of Magnetic Fields on Selected Physiological 2 Parameters of Blood and Tissues in Mice 3 Hani M. Abdelsalama and Mohammed Elywab 4 a Department of Zoology, Faculty of Science, Zagazig University 5 b Department of Biophysics, Faculty of Science, Zagazig University 6 Running title: Effect of magnetic fields on antioxidants and enzymes 7 Manuscript pages: 19, Figures: 7, Tables: 7. 8 *Corresponding author: 9 Hani M. Abdelsalam 10 Department of Zoology, Faculty of Science, Zagazig University Tel.:0020552303252 11 Tel.: +201008051012 E-mail:[email protected] 12 Co-author: 13 Mohammed Elywa E-mail: [email protected] 14 15 Abstract 16 This study aimed to highlight the influence of exposure to different applied magnetic fields (MFs) on 17 SOD, MDA and GSH levels in the liver, LDH and CPK activities in the muscle and γ-aminobutyric acid levels 18 in the brain, as well as some haematological parameters. Adult male albino Swiss mice were divided into 5 19 equal groups (n = 6), the control group (untreated) and four exposure groups that were exposed to MFs of 20, 20 40, 60 and 80 Gauss for 5 min/day for 5 days.: Exposure to MFs induced significant decreases in total GSH 21 levels and SOD activity but a significant increase in MDA levels in the liver.
    [Show full text]
  • TOPIC 5 Lab – B: Diagnostic Tools & Therapies – Blood & Lymphatic
    TOPIC 5 Lab – B: Diagnostic Tools & Therapies – Blood & Lymphatic Disorders Refer to chapter 17 and selected online sources. Refer to the front cover of Gould & Dyer for normal blood test values. Complete and internet search for videos from reliable sources on blood donations and blood tests. Topic 5 Lab - A: Blood and Lymphatic Disorders You’ll need to refer to an anatomy & physiology textbook or lab manual to complete many of these objectives. Blood Lab Materials Prepared slides of normal blood Prepared slides of specific blood pathologies Models of formed elements Plaque models of formed elements Blood typing model kits Blood Lab Objectives – by the end of this lab, students should be able to: 1. Describe the physical characteristics of blood. 2. Differentiate between the plasma and serum. 3. Identify the formed elements on prepared slides, diagrams and models and state their main functions. You may wish to draw what you see in the space provided. Formed Element Description / Function Drawing Erythrocyte Neutrophil s e t y c Eosinophils o l u n a r Basophils Leukocytes G e Monocytes t y c o l u n Lymphocytes a r g A Thrombocytes 4. Define differential white blood cell count. State the major function and expected range (percentage) of each type of white blood cell in normal blood. WBC Type Function Expected % Neutrophils Eosinophils Basophils Monocytes Lymphocytes 5. Calculation of the differential count? 6. Define and use in proper context: 1. achlorhydria 5. amyloidosis 2. acute leukemia 6. anemia 3. agnogenic myeloid metaplasia 7. autosplenectomy 4. aleukemic leukemia 8. basophilic stippling 9.
    [Show full text]
  • Pathology Course
    Pathology Course Kindly Sponsored by: Edited by: Michelle Kunc, Jhia Teh, Sally Barker and Yvonne Tsitsiou 1 Introduction The Medical Education Society (MedED) was established in 2004 by three students who were keen to develop schemes whereby senior students tutor younger ones - ‘peer-to- peer’ learning. It was decided that teaching would be outside the formal curriculum and the topics covered would reflect learning needs identified by members of the society and student body. This year we have coordinated PACES and Pathology revision courses, which are being delivered by past ICSM students. We hope you enjoy our Year 5 events and find their content useful for your revision. We would like to thank all the doctors involved in the production of this guide for their support and for taking time out of the schedules to come back and teach us. We would also like to thank the previous MedED guide editors: • 2016-2017: Daniel Campioni-Norman, Rhys Smith, Helen-Cara Younan and Rebekah Judge • 2017-2018: Charlie Caird, Stephanie EzeKwe, Mohammad Fallaha, Samyukta Sundar • 2018-2019: Sophia von Widekind, Lasith Ranasinghe, Daniel Huddart, Alex Huddart If you have any questions please contact us at [email protected]. Please note: MedED does not represent the ICSM Faculty or Student Union. This guide has been produced by students and the Pathology Course lecturers. We have made every effort to ensure that the following information is accurate and reliable. However, this guide should not be used to replace formal ICSM teaching and education
    [Show full text]
  • Ionic and Osmotic Equilibria of Human Red Blood Cells
    American Journal of Scientific Research ISSN 2301-2005 Issue 86 March, 2013, pp.177-187 http://www.americanjournalofscientificresearch.com Ionic and Osmotic Equilibria of Human Red Blood Cells Omar S. Hajjawi Department of Biology, Arab American University P.O. Box 240, Jenin, Israeli Occupied Territories of Palestine E-mail: [email protected] Tel: 04 2510801-6, Ext.429; Fax: 04 2510810 Abstract A healthy mature human red blood cell (RBC) lacks nucleus and it is a disc-shaped under physiological conditions (Li et al., 2007). The biconcave discocyte RBC has flexible bi-layer membrane with a high surface-to-volume ratio that facilitates large reversible elastic deformation as it repeatedly passes through narrow capillaries during microcirculation which is necessary to transport oxygen and carbon dioxide though haemoglobin molecules which are contained in the RBC intracellular are essential for gas transport within the circulation. The discocyte shape of RBC is encoded in the mechanical properties of its bilayer-membranes: 7.8µm in diameter; 136µm2 in surface area, 85.1µm3 in volume and 1.7-2.2µm in thickness (Tse and Lux, 1999; Turgeon, 2004). Some variations in size, shape or colour of RBC may be seen on microscopic examination with Write's Romanosky – type stain (Dunphy (2010). The movement and distribution of ions across RBC membranes is greatly influenced by the presence of charged impermeable macromolecules which prompt an equivalent number of oppositely charged permeable ions to remain with them in the same compartment in which they occur (Donnan, 1911; Lang, 2007). The main basic function of the sodium pump is to maintain the Na+/K+ gradients across the membrane.
    [Show full text]
  • Compendium of Urinalysis Urine Test Strips and Microscopy
    Compendium of urinalysis Urine test strips and microscopy Main disease indications Urinary Tract Infection Interesting facts Are you aware of that … • More than 500 million people – 10% • One in 20 deaths is caused by diabetes; of the world’s population – have some 8,700 deaths every day; six every min- form of kidney damage 1 ute 3 • Urinary tract infections are the sec- • By 2030, almost 23.6 million people will ond most common type of infection in die from cardiovascular disease, mainly the human body 2 heart disease and stroke 4 1 22 Content 1 Main disease indication Urinary tract infection 8 Kidney disease 10 Diabetes 14 2 From urine fortune telling to real time diagnosis History of urinalysis 18 Application areas for urine test strips 20 Pre-analytical treatment and test procedure 22 3 Characteristics of urine test strips from Roche Composition and benefit of the test strip 28 Parameters of urine test strips 32 Detection of microalbuminuria with micral-test 56 4 Drug interferences in urine Influencing factors 60 5 Automated urinalysis Urine test strip systems 64 6 Urine microscopy in differential diagnosis Microscope 70 7 Urine particles and formed elements Blood cells 74 White blood cells 74 Red blood cells 76 Epithelial cells 78 Squamous epithelial cells 78 Renal tubular cells 79 Transitional epithelial cells 80 Atypical cells 81 Casts 82 Hyaline casts 82 Granular casts 84 Pigmented casts 85 Waxy casts 86 Red blood cell casts 87 White blood cell casts 88 Epithelial cell casts 88 Fatty casts 89 Cylindroids 90 Rare casts 90 Pseudo
    [Show full text]
  • A Laboratory Guide to Clinical Hematology
    A Laboratory Guide to Clinical Hematology A Laboratory Guide to Clinical Hematology A Laboratory Guide to Clinical Hematology VALENTIN VILLATORO AND MICHELLE TO EDMONTON A Laboratory Guide to Clinical Hematology by Michelle To is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. Please be aware that the content for the entirety of this eBook is subject to a creative common license: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) You are free to: Share — copy and redistribute the material in any medium or format Adapt — remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. Contents Authors & Editors ................................................................................................................................... xii Creative Commons License and Citation ............................................................................................... xiii Contact Information and Feedback ........................................................................................................
    [Show full text]
  • Morphology of Leukaemias
    +Model HGMX-57; No. of Pages 7 ARTICLE IN PRESS Rev Med Hosp Gen Méx. 2015;xxx(xx):xxx---xxx ´ ´ www.elsevier.es/hgmx REVIEW ARTICLE Morphology of leukaemias a a b c W. Ladines-Castro , G. Barragán-Ibanez˜ , M.A. Luna-Pérez , A. Santoyo-Sánchez , a a a,∗ J. Collazo-Jaloma , E. Mendoza-García , C.O. Ramos-Penafiel˜ a Servicio de Hematología, Hospital General de México ‘‘Dr. Eduardo Liceaga’’, Mexico City, Mexico b Facultad de Artes y Diseno,˜ Universidad Nacional Autónoma de México, Mexico City, Mexico c Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico Received 4 April 2015; accepted 11 June 2015 KEYWORDS Abstract Acute leukaemias are characterised by uncontrolled proliferation of immature blood Diagnostic techniques cells with lymphoid or myeloid lineage. Morphological classification is based on the identifica- and procedures; tion of the leukaemia cell line and its stage of differentiation. The first microscopic descriptions Lymphoid leukaemia; dating from the 1930s pointed to 2 different types of leukaemia cells: lymphoid and myeloid. In Myeloid leukaemia; 1976, the consensus that led to the French-American-British (FAB) classification was achieved. Cellular morphology This includes criteria for identifying myeloid and lymphoid leukaemias, and gives a list of mor- phological subtypes, describing how these affect the patient’s prognosis. Today, despite new classifications based on sophisticated studies, FAB classification is widely used by experts due to its technical simplicity, good diagnostic reliability and cost-effectiveness. © 2015 Sociedad Médica del Hospital General de México. Published by Masson Doyma México S.A. All rights reserved.
    [Show full text]
  • Red Blood Cell Abnormalities As Seen with May-Grünwald-Giemsa (MGG) Staining
    Red blood cell abnormalities as seen with May-Grünwald-Giemsa (MGG) staining Microcyte Macrocyte Megalocyte Microspherocyte Description Description Description Description Ø < 7 µm, in the smear smaller Large red blood cell, Ø 10 µm, Large red blood cell, oval shape, Small red blood cell, Ø < 6 µm, diameter than the nucleus of a central pallor present no central pallor, always hyper- normal volume, no central small lymphocyte, often chromic pallor Incidence hypochromic Reticulocytes are always Incidence Incidence Incidence macrocytes and reflect the Vitamin B12 or Hereditary spherocytosis Iron deficiency regeneration of erythropoiesis. folate deficiency Hypochromic red blood cell Anulocyte Polychromatic red blood cell Echinocyte Description Description Description Description Central pallor > 1/3 of the cell Pronouncedly hypochromic red Blue-tinged red blood cell with Crenated red cell with evenly surface, often microcytic blood cell with small, peripheral remnants of diffusely distributed distributed and uniformly sized ring of haemoglobin, always RNA, often macrocytic spicules Incidence hypochromic Iron deficiency anaemia Incidence Incidence Incidence Reticulocytosis, unspecific with Artefact. In vitro phenomenon Iron deficiency anaemia severe anaemia and in vivo with acidosis and pH hyperosmolarity Acanthocyte Fragmented red cell Sickle cell Pincered cell Description Description Description Description Membrane spikes of irregular Red blood cell with intact con- Red blood cell with pointed Mushroom-shaped red blood size, unevenly distributed
    [Show full text]
  • Medication-Induced Blood Dyscrasias
    MEDICATION-INDUCED BLOOD DYSCRASIAS: Diagnosis, Treatment And Prevention Jassin M. Jouria, MD Dr. Jassin M. Jouria is a medical doctor, professor of academic medicine, and medical author. He graduated from Ross University School of Medicine and has completed his clinical clerkship training in various teaching hospitals throughout New York, including King’s County Hospital Center and Brookdale Medical Center, among others. Dr. Jouria has passed all USMLE medical board exams, and has served as a test prep tutor and instructor for Kaplan. He has developed several medical courses and curricula for a variety of educational institutions. Dr. Jouria has also served on multiple levels in the academic field including faculty member and Department Chair. Dr. Jouria continues to serves as a Subject Matter Expert for several continuing education organizations covering multiple basic medical sciences. He has also developed several continuing medical education courses covering various topics in clinical medicine. Recently, Dr. Jouria has been contracted by the University of Miami/Jackson Memorial Hospital’s Department of Surgery to develop an e-module training series for trauma patient management. Dr. Jouria is currently authoring an academic textbook on Human Anatomy & Physiology. ABSTRACT Although drug-induced hematologic disorders are less common than other types of adverse reactions, they are associated with significant morbidity and mortality. Some agents, such as hemolytics, cause predictable hematologic disease, but others induce idiosyncratic reactions not directly related to the drug’s pharmacology. The most important part of managing hematologic disorders is the prompt recognition that a problem exists. The main mechanisms to manage hematologic disorders include vigilance to observe signs and symptoms indicating a blood disorder and patient education of the warning symptoms to alert them of the need to report a condition to their primary care provider or an emergency health team.
    [Show full text]