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Objectives Epstein-Barr virus (EBV) is a member of the herpes virus that causes infectious mononucleosis (IM). Downey cell is the atypical lymphocyte of IM and can be seen in various conditions. Peripheral blood smear (PBS) microscopic evaluation is used to identify Downey cells. A lack of experienced professionals or professional errors may obstruct early and accurate diagnostics for the microscopic evaluation. The main objective of this study is to create a decision support system by digitizing the PBS samples. A general tool providing an inexpensive and measurable solution is envisioned to analyze the PBS samples in detail to give alerting flags to prevent missing Downey cells in manual analysis.Methods The PBS dataset collected was split into Downey positives and negatives. The negative set consisted of 5 leucocyte subtypes. Mantiscope, a cloud-based slide scanner system, was used to collect images from the physical PBS samples. Clinically and laboratory-confirmed 35 IM patients and 124 healthy PBS slides were selected for this procedure. A number of cell counts were obtained after the application of annotation and augmentation methods, and a partially balanced dataset was created for the artificial intelligence (AI) network training. The verification steps included the calculation of sensitivity, specificity, and Cohen's kappa metrics from the partitioned testing set that was not used during training. A validation process was also performed over the manually identified PBS samples to measure whether the algorithm noticed the samples or not.Results After testing this setup, we have observed 98 % sensitivity and 99 % specificity for Downey cells. According to the validation procedure of Downey positive and negative samples that were carried out by the physicians, a sensitivity of 57 %, specificity of 100 %, and Cohen's kappa value of 0.5 were observed. Besides, the accuracy was found to be 66 % according to the physicians' evaluations employing the digital images

Objective: As a member of the human herpesvirus family, Epstein-Barr virus (EBV) primarily replicates in lymphocytes but also may replicate in the epithelial cells of the pharynx and parotid duct. The infection is spread primarily by saliva and the incubation period is four to eight weeks. Infectious mononucleosis (IM) is a clinical syndrome caused by EBV that is particularly common in adolescents and children. Typical features of IM include fever, pharyngitis, adenopathy, malaise, and an atypical lymphocytosis. Splenomegaly, hepatomegaly, jaundice, and splenic rupture can occur. The platelet mass index (PMI) is related to platelet functionality and platelet function has an effect on the inflammation cascade. This study is planned to examine the role of PMI in the pre-diagnosis of IM. Methods: Between the years 2010-2019, 274 patients who were tested for EBV antibodies were included in the study and the PMI values of EBV positive group was compared to EBV negative and the control group. Results: EBV positive group has lower PMI values than EBV negative and control group. Conclusion: EPMI can be easily calculated using a CBC test and can be a used as a pre-diagnostic tool for the existence of IM.

Objectives Epstein-Barr virus (EBV) is a member of the herpes virus that causes infectious mononucleosis (IM). Downey cell is the atypical lymphocyte of IM and can be seen in various conditions. Peripheral blood smear (PBS) microscopic evaluation is used to identify Downey cells. A lack of experienced professionals or professional errors may obstruct early and accurate diagnostics for the microscopic evaluation. The main objective of this study is to create a decision support system by digitizing the PBS samples. A general tool providing an inexpensive and measurable solution is envisioned to analyze the PBS samples in detail to give alerting flags to prevent missing Downey cells in manual analysis.Methods The PBS dataset collected was split into Downey positives and negatives. The negative set consisted of 5 leucocyte subtypes. Mantiscope, a cloud-based slide scanner system, was used to collect images from the physical PBS samples. Clinically and laboratory-confirmed 35 IM patients and 124 healthy PBS slides were selected for this procedure. A number of cell counts were obtained after the application of annotation and augmentation methods, and a partially balanced dataset was created for the artificial intelligence (AI) network training. The verification steps included the calculation of sensitivity, specificity, and Cohen's kappa metrics from the partitioned testing set that was not used during training. A validation process was also performed over the manually identified PBS samples to measure whether the algorithm noticed the samples or not.Results After testing this setup, we have observed 98 % sensitivity and 99 % specificity for Downey cells. According to the validation procedure of Downey positive and negative samples that were carried out by the physicians, a sensitivity of 57 %, specificity of 100 %, and Cohen's kappa value of 0.5 were observed. Besides, the accuracy was found to be 66 % according to the physicians' evaluations employing the digital images

BACKGROUND AND AIM: Downey cell is the atypical lymphocyte of infectious mononucleosis. It can be seen in a variety of conditions, but are often increased in infectious mononucleosis due to Epstein-Barr virus (EBV) infection. These cells can be identified through peripheral blood smear (PBS) for the diagnosis. Manual microscopy is the gold standard to evaluate Wright-Giemsa stained peripheral blood smear (PBS). As an alternative to manual microscopy, slide scanner systems (Mantiscope, Sysmex, etc…) are used to digitize the biological samples and make them available for physicians to analyze the samples with Artificial Intelligence (AI) tools. The main objective of this study is to create a decision support system (using AI) that can alert the physician for this type of cells to increase the rate of true diagnosis. METHODS: A dataset (PBS slides) examined via manual microscopy is collected from 25 patients with infectious mononucleosis and 124 healthy controls. Mantiscope slide scanner system is used to digitize the PBS slides. Each slide is scanned with 100x magnification via collecting approximately 400 images per slide. Physicians have annotated the digitized images through Mantiscope’s cloud-based annotation platform and labeled the cells as leukocytes, blasts and Downey cells. Data augmentation methods such as mirroring in vertical/ horizontal/ vertical and horizontal are used to create a balanced dataset to train deep learning-based AI platform. Objective measurement metrics (sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)) are calculated to create insights about the effectivity of the decision support system. RESULTS: For a large variety of dataset comprising each normal leukocyte type and including blasts, identification of Downey can be performed with a higher sensitivity and specificity of 0.97 and 0.98, respectively. Cohen’s kappa analysis was conducted to evaluate the agreement between physicians and AI in te

8.7, 4.8, 2.3, 0.4, and 0.1 (x103/µL), for leukocyte, neutrophil, lymphocyte, eosinophil and basophil counts. The average IgE value of negatives is 155.4 IU/mL. Conclusions: The positivity rate of 3.6% in high-income patients supports that this disease still important in Turkey. Female patients, especially in the middle age group, presenting with gastrointestinal system complaints, should be evaluated for echinococcosis, even if their biochemical/hematological parameters are normal., leukocyte, neutrophil, lymphocyte, eosinophil, and basophil values were 5.9, 3.4, 1.8 and 0.2 (x103/µL). The mean values for ALT, AST, urea, creatinine and CRP of negative patients were 30.0U/L, 27.9U/L, 16.5mg/dL, 0.9mg/dL and 14.2mg/dL, 27 (49.9%) females. Only 2 (3.6%) Turkish female patients were found positive. The positivity rate in women was 7.4%, and their diagnosis was confirmed radiologically (ultrasonography and computed tomography). The patients’ ages range from 1 to 81 (mean 41.2), whereas the seropositives' average age is 31.2. Six (10.1%) of patients were children and they were referred from Pediatrics and Pediatric Surgery clinics. Including one of the positive patients, 67.4% (33/49) of adults, applied to Gastroenterology Clinic. The other positive case was referred from Orthopedics and Traumatology Polyclinic. Mean ALT, AST, urea, creatinine, and CRP values of positive patients were 16.0U/L, 16.5U/L, 8.6mg/dL, 0.6mg/dL and 6.1mg/dL, 28 (50.1%) males, titers of 1/160 and above were considered as positive. Results: Our patients belong to the middle-upper and upper economic income group: 16.4% from foreign countries, Objectives: Serological, biochemical, and hemogram test results provide important clues in diagnosis and follow-up of echinococcosis. In this context, the results of the patients who were admitted to our hospital with a preliminary diagnosis of echinococcosis were evaluated retrospectively. Materials-Methods: Between 01 January 2005-31 December 2021, 55 patients were included in this study. The samples were analyzed by indirect hemagglutination method (Hydatidose, Fumouze Laboratoires, France), ve 0,1 (x103/µL)’dir. Negatif olanların IgE değeri ortalaması 155,4IU/mL olup, pozitif hastaların bu değeri bilinmemektedir. Sonuç: Hastanemize başvuran üst ekonomik gelir grubundaki hastalarda %3,6’lık pozitiflik oranı saptanması, Türkiye’de halen bu hastalığın önemini koruduğu görüşünü desteklemektedir. Gastrointestinal sistem şikayetleri ile başvuran özellikle ortaya yaş grubundaki kadın hastaların biyokimyasal/hematolojik parametreleri normal dahi olsa ekinokokkozis açısından değerlendirilmesi önerilir., 0,4, 2,3, 4,8, 0,9mg/dL ve 14,2mg/dL, lökosit, nötrofil, lenfosit, eozinofil ve bazofil için 8,7, 16,5 mg/dL, 27,9U/L, 1,8 ve 0,2 (x103/µL) olarak belirlenmiştir. Negatif hastaların ortalama değerleri ise ALT, AST, üre, kreatinin ve CRP için 30,0U/L, 3,4, 0,6mg/dL ve 6,1mg/dL, lökosit, nötrofil, lenfosit, eozinofil ve bazofil değerleri 5,9, 8,6mg/dL, 16,5U/L, Amaç: Ekinokokkozisin tanısı temel olarak görüntüleme yöntemlerine, tedavisi ise cerrahiye dayanmaktaysa da hastaların tanısı ile izleminde seroloji, biyokimya ve hemogram sonuçları da önemli ipuçları sunmaktadır. Bu kapsamda Hastanemize ekinokokkoz ön tanısıyla başvuran hastaların sonuçları retrospektif olarak değerlendirilmiştir. Gereç ve Yöntem: Çalışmaya 01. Ocak. 2005-31.Aralık.2021 tarihleri arasında TOBB-ETÜ Hastanesi Merkez Laboratuvarına ekinokokkoz ön tanısıyla çeşitli kliniklerden gelen 55 hastaya ait çoklu serum örnekleri alınmış, hastaların verileri hastane bilgi sisteminden çekilmiştir. Örnekler, indirekt hemaglütinasyon (IHA) yöntemiyle ticari kit (Hydatidose, Fumouze Laboratoires, France) ile çalışılmış, 1/160 ve üzeri titreler pozitif olarak kabul edilmiştir. Bulgular: Hastanemize başvuran hastalar orta-üst ve üst ekonomik gelir grubunda yer almakta olup %16,4’ü yabancı uyruklu, 28’i (%50,1) erkek, 27’si (%49,9) kadındır. Sadece iki (%3,6) Türk kadın hastada pozitiflik saptanmıştır. Kadınlardaki pozitiflik oranı %7,4 olup tanıları radyolojik olarak da (ultrasonografi ve bilgisayarlı tomografi) onaylanmıştır. Başvuranların yaşları 1-81 (ortalama 41,2) arasında iken seropozitiflerin yaş ortalaması 31,2’dir. Başvuranların 6’sı (%10,1) çocuk olup Pediatri ve Çocuk Cerrahisi polikliniklerinden yönlendirilmiştir. Pozitif hastalardan birisi de dahil olmak üzere erişkinlerin %67,4’ü (33/49) Gastroenteroloji Polikliniğine başvurmuştur. Diğer pozitif olgu ise Ortopedi ve Travmatoloji Polikliniğinden yönlendirilmiştir. Pozitif hastaların ortalama ALT, AST, üre, kreatinin ve CRP değerleri 16,0U/L

[No Abstract Available]

Respiratory syncytial virus (RSV) is a viral pathogen that causes respiratory system infections in childhood. In this study, we aim to examine the role of Platelet to lymphocyte ratio (PLR) and Platelet to Lymphocyte and monocyte ratio (PLT/LY+MO) values in the prediction of RSV infection and in the differentiation of upper and lower respiratory tract RSV infections. Complete blood counts and RSV Antigen test results of 76 patients, between the age of 0 and 12 were investigated retrospectively. PLR values are calculated using Platelet Count/Lymphocyte Count formula, whereas PLMR values are calculated using Platelet Count/Lymphocyte Count+Monocyte Count. Out of 76, 32 patients were diagnosed as having RSV infection due to RSV antigen test. The percentage lymphocyte and monocyte as well as the platelet count were significantly higher in RSV positive group. Monocyte percentage in lower respiratory tract RSV infection was significantly lower compared to upper respiratory tract RSV infection. Our study revealed that blood parameters like lymphocyte and monocyte percentage and platelet count may be an important clue for the clinician for RSV infection and also, play a role as a guide before advanced techniques. In addition, percentage of monocyte can be useful to detect the lower respiratory tract involvement in RSV infection., Respiratuar sinsityal virüs (RSV), çocukluk çağında solunum sistemi enfeksiyonlarına neden olan viral bir patojendir. Bu çalışmada Trombosit/lenfosit oranı (PLR) ve Platelet/Lenfosit oranının (PLT/LY+MO) RSV enfeksiyonunun ön tanısında ve üst-alt solunum yolu RSV indfeksiyonlarının ayrımındaki rolünü incelemeyi amaçladık. 0-12 yaş arası 76 hastanın tam kan sayımı ve RSV Antijen test sonuçları geriye dönük olarak incelenmiştir. PLR değerleri Trombosit Sayısı/Lenfosit Sayısı formülü kullanılarak hesaplanırken, PLMR değerleri Trombosit Sayısı/Lenfosit Sayısı+Monosit Sayısı kullanılarak hesaplanmıştır. RSV antijen test sonuçlarına göre 76 hastanın 32'sine RSV enfeksiyonu teşhisi konmuştur. RSV pozitif grupta lenfosit ve monosit yüzdesi ile trombosit sayısı anlamlı derecede yüksek bulunmuştur. Alt solunum yolu RSV enfeksiyonunda monosit yüzdesinin ise üst solunum yolu RSV enfeksiyonuna göre anlamlı derecede düşük olduğu saptanmıştır. Çalışmamız lenfosit ve monosit yüzdesi ile trombosit sayısı gibi kan parametrelerinin RSV enfeksiyonu için klinisyene bir ipucu verebileceğini ve ayrıca ileri teknikler öncesinde yol gösterici rol oynayabileceğini ortaya koymuştur. Ek olarak, monosit yüzdesinin, RSV enfeksiyonunda alt solunum yolu tutulumunu saptamak için faydalı olabileceği sonucuna varılmıştır.

Aim: Panic values are laboratory test results that indicate that the patient may be in a life-threatening condition if urgent action is not taken. Each medical laboratory should determine their panic values and also they have to report and document the results. Chronic myeloproliferative neoplasms (MPN), including malign diseases such as polycythemia vera, essential thrombocythemia, primary myelofibrosis and chronic myeloid leukemia, is a malignant and clonal disease of hematopoietic tissue. In 2016, World Health Organization (WHO) updated the criteria of classification for hematopoietic and lymphoid tissue tumors. The aim of this study is to compare the panic value reports of our laboratory with the number of tests that exceed the limit values for chronic MPNs determined according to the new WHO criteria. Material and Methods: In the study, the results of complete blood count of 58223 patients over the age of 15 were evaluated. Hemoglobin, hematocrit, platelet and leukocyte counts were evaluated and compared according to reported the panic values of our laboratory and the WHO criteria for chronic MPN. Results: When the hemoglobin values are evaluated due to currently used panic values instead of WHO criteria, the necessity of bone marrow examination is overlooked and 1.13% of women and 8.90% of men could not be followed in terms of chronic MPN. Also, the hematocrit values of 9.59 % of women and 8.52% men could not be informative. The hemoglobin values in 0.68% of women and in 1.74% of men, hematokrit için kadınlarda %0,94, erkeklerde %0,38’dir. Trombosit sayısı için bu oran %2,20 iken, lökosit sayısı için %24,78’dir. Sonuç: Çalışmamızın sonuçları kronik MPN açısında uyarıcı olabilmesi için panik değerlerin 2016 DSÖ kılavuzundaki kronik MPN kriterlerine göre gözden geçirilerek yeniden düzenlenmesi gerekliliğini doğurmuştur., Amaç: Panik değerler, laboratuvar test sonuçlarının acil müdahale edilemediği takdirde hastanın hayati tehlikesi olabileceğini işaret eden sınır değerlerdir. Her tıbbi laboratuvar panik değerlerini her test ve durum için ilgili klinik ile beraber saptamalıdır ve bildirimlerini zamanında yaparak dokümante etmelidir. Polisitemia vera, esansiyel trombositemi, primer myelofibrozis ve kronik myelositer lösemi gibi malign hastalıkları içeren kronik myeloproliferatif neoplaziler (MPN), hematopoietik dokunun, malign ve klonal bir hastalığıdır. Dünya Sağlık Örgütü (DSÖ) 2016 yılında hematopoetik ve lenfoid doku tümörlerinin sınıflamasında güncelleme yapmıştır. Bu çalışmadaki amaç laboratuvarımızdan yapılmış panik değer bildirimleri ile yeni DSÖ ölçütlerine göre belirlenmiş kronik MPN sınır değerlerinin üzerinde çıkan test sayılarını karşılaştırmaktır. Gereç ve Yöntemler: Çalışmada 15 yaş üzeri 58223 hastaya ait tam kan sayımı sonucu değerlendirmeye alınmıştır. Elde edilen hemoglobin, hematokrit, trombosit ve lökosit sayısı panik değer bildirim sayı veya yüzdeleri laboratuvarımızın panik değerlerine ve kronik MPN için DSÖ kriterlerine göre değerlendirilmiş ve karşılaştırılmıştır. Bulgular: Kemik iliği incelemesi yapılması için uyarıcı olması gereken hemoglobin düzeyleri için mevcut panik değer sınırlarının kullanılması halinde kadınlarda %1,13, erkeklerde %8,90, the hematocrit values in 0.94 % of women and in 0.38% of men could not be taken as a warning for chronic MPN without performing marrow examination. For platelet and leukocyte counts the rates are 2.20% and 24.78%, respectively. Conclusion: In order to provide early information in terms of chronic MPN, panic values should be reviewed and rearranged according criteria in the 2016 WHO guideline., hematokrit düzeyleri için kadınlarda yaklaşık %9,59, erkeklerde %8,52 oranında hasta gözden kaçarak kronik MPN yönünden takibe alınamamaktadır. Kemik iliği incelemesi olmaksızın kronik MPN lehine uyarıcı kabul edilmesi gereken oranlar hemoglobin için kadınlarda %0,68, erkeklerde %1,74

BACKGROUND AND AIM: Downey cell is the atypical lymphocyte of infectious mononucleosis. It can be seen in a variety of conditions, but are often increased in infectious mononucleosis due to Epstein-Barr virus (EBV) infection. These cells can be identified through peripheral blood smear (PBS) for the diagnosis. Manual microscopy is the gold standard to evaluate Wright-Giemsa stained peripheral blood smear (PBS). As an alternative to manual microscopy, slide scanner systems (Mantiscope, Sysmex, etc…) are used to digitize the biological samples and make them available for physicians to analyze the samples with Artificial Intelligence (AI) tools. The main objective of this study is to create a decision support system (using AI) that can alert the physician for this type of cells to increase the rate of true diagnosis. METHODS: A dataset (PBS slides) examined via manual microscopy is collected from 25 patients with infectious mononucleosis and 124 healthy controls. Mantiscope slide scanner system is used to digitize the PBS slides. Each slide is scanned with 100x magnification via collecting approximately 400 images per slide. Physicians have annotated the digitized images through Mantiscope’s cloud-based annotation platform and labeled the cells as leukocytes, blasts and Downey cells. Data augmentation methods such as mirroring in vertical/ horizontal/ vertical and horizontal are used to create a balanced dataset to train deep learning-based AI platform. Objective measurement metrics (sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)) are calculated to create insights about the effectivity of the decision support system. RESULTS: For a large variety of dataset comprising each normal leukocyte type and including blasts, identification of Downey can be performed with a higher sensitivity and specificity of 0.97 and 0.98, respectively. Cohen’s kappa analysis was conducted to evaluate the agreement between physicians and AI in te