Search

This case report presents a male in his 30s with pernicious anaemia, initially diagnosed with autoimmune haemolytic anaemia and thrombocytopenia. Despite improvement with treatment, he developed bilateral leg weakness and numbness, ultimately diagnosed as peripheral neuropathy. Further investigations revealed a spectrum of haematological and neurological manifestations associated with B12 deficiency, challenging the typical illness script of pernicious anaemia. This report underscores the importance of recognising variations in clinical presentation and highlights the need for expanded illness scripts to guide accurate diagnosis and management., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Common minimally invasive methods for acquiring samples for flow cytometric immunophenotyping (FCI) include fine-needle aspiration (FNA) and needle core biopsy (NCB). FCI requires a sufficient quantity of viable cells for adequate evaluation., Methods: We collected patient data from our files of all FCI cases sampled via FNA or NCB from January 1, 2003 and June 1, 2012. Total Viable Cells (TVC) was calculated by multiplying the volume, viability, and concentration and then converted to logarithmic scale as "Log TVC." Statistical analysis was performed using SPSS., Results: Five hundred seventy-one FCI cases at our institution were reviewed covering the period from 2003 to 2012 and 456 total cases were analyzed. One hundred sixteen cases were sampled by NCB and 340 were sampled by FNA. Comparing FNA to NCB subgroups demonstrated FNA to be superior in mean specimen viability, TVC, and cases with a final FCI interpretation. The cellularity of the sample (in Log TVC) correlates with the likelihood of achieving a FCI interpretation. The point where at least 50% of cases have a diagnostic FCI interpretation occurs between Log TVC of 5.0-5.25. However, FNA based cases had a higher proportion of samples with an indeterminate final diagnosis., Conclusions: FNA was found to be significantly superior to NCB in obtaining material for FCI. However, NCB resulted in fewer indeterminate final diagnoses due to benefit of histologic correlation. In our opinion, NCB for histology combined with dedicated FNA material for FCI may yield the best results for a minimally invasive approach to the diagnosis of hematologic neoplasms., (© 2014 Clinical Cytometry Society.)

Background: Common minimally invasive methods for acquiring samples for flow cytometric immunophenotyping (FCI) include fine needle aspiration (FNA) and needle core biopsy (NCB). FCI requires a sufficient quantity of viable cells for adequate evaluation. Methods: We collected patient data from our files of all FCI cases sampled via FNA or NCB from 1/1/03 and 6/1/12. Total Viable Cells (TVC) was calculated by multiplying the volume, viability and concentration and then converted to logarithmic scale as "Log TVC." Statistical analysis was performed using SPSS. Results: 571 FCI cases at our institution were reviewed covering the period from 2003 to 2012 and 456 total cases were analyzed. 116 cases were sampled by NCB and 340 were sampled by FNA. Comparing FNA to NCB subgroups demonstrated FNA to be superior in mean specimen viability, TVC, and cases with a final FCI interpretation. The cellularity of the sample (in Log TVC) correlates with the likelihood of achieving a FCI interpretation. The point where at least 50% of cases have a diagnostic FCI interpretation occurs between Log TVC of 5.0 - 5.25. However, FNA based cases had a higher proportion of samples with an indeterminate final diagnosis. Conclusions: FNA was found to be significantly superior to NCB in obtaining material for FCI. However, NCB resulted in fewer indeterminate final diagnoses due to benefit of histologic correlation. In our opinion, NCB for histology combined with dedicated FNA material for FCI may yield the best results for a minimally invasive approach to the diagnosis of hematologic neoplasms. © 2014 Clinical Cytometry Society., (Copyright © 2014 Clinical Cytometry Society.)

Standard curves of 5 antibiotics were determined in an antibiotic assay using bilayer and monolayer agar plates and AOAC-specified test organisms and agar media. Micrococcus luteus ATCC 9341a and antibiotic medium No. 2 were used to prepare the penicillin G standard curve. The same organism and antibiotic medium No. 11 were used to prepare the erythromycin standard curve. Standard curves for streptomycin, tetracycline, and gentamicin were prepared, respectively, with antibiotic medium No. 5 and Bacillus subtilis ATCC 6633, antibiotic medium No. 8 and B. cereus ATCC 11778, and antibiotic medium No. 11 and Staphylococcus epidermidis ATCC 12228. Assays of inhibition by meat fortified with penicillin, streptomycin, gentamicin, tetracycline, erythromycin also were performed on monolayer and bilayer plates. Differences in standard curves and inhibitory responses obtained with monolayer and bilayer plates were < 10%. Thus, monolayer plates are acceptable for use in analyses of meat and poultry for antibiotics residues, with savings in laboratory resources and time.

A multispecies identification field test (MULTI-SIFT) was developed for detection of beef, poultry, pork, sheep, horse, and deer in a wide variety of raw meat products. The test is an adaptation of previously developed field screening immunodiffusion tests for detection of single species. MULTI-SIFT was demonstrated to be specific, relatively sensitive, and accurate in the complete speciation of 100 meat samples.

A rapid equine serological test (REST) has been developed for detection of horse meat in a wide variety of raw meat products. The test is an adaptation of previously developed field screening immunodiffusion tests for beef, poultry, pork, and sheep detection. Results show that the REST test was specific, sensitive, and accurate in the analysis of 101 samples.

Enzyme-linked immunosorbent assays (ELISA) are described for the detection of poultry and pork in cooked and canned meat foods. These assays are based on species-specific, polyclonal antibodies raised against heat-resistant antigens. The heat-resistant antigens were isolated from raw skeletal muscle tissue of pork and chicken and were found to be immunoreactive even after heating to 120 degrees C for 15 min. The poultry ELISA could detect chicken or turkey at the 126 ppm level, and the pork ELISA could detect pork at the 250 ppm level. Samples of frankfurters, bolognas, pressed meats, canned baby foods, and canned spreads were prepared by simple aqueous extractions.

An Overnight Rapid Bovine Identification Test (ORBIT) has been developed as a serological screen test for species verification of raw, whole tissue, bovine meat products. The test, an agar-gel immunodiffusion technique, uses stabilized reagent paper discs and prepared agar plates that have a printed template for correct placement of test components. This test is reliable, practical, economical, and easily performed in the field, such as at a meat import inspection station. The only nonbovine species found to react in the test are the bovine-related species of American bison (buffalo) and water buffalo (from Australia); however, these rare-occurring species do not present a problem for the intended application of the test. Stability of all test components, when stored in a refrigerator, is excellent for at least 1 year. The nature and stability of the test make it suitable for commercial development into test kits which should be highly practical and economical for wide availability and application of this procedure to meat inspection programs concerned with species verification.

Ten laboratories each analyzed 30 raw meat and raw meat product samples in a collaborative study of the ORBIT (overnight rapid bovine identification test) and PROFIT (poultry rapid overnight field identification test) serological field screening tests for the detection of beef and poultry. Versatility of the tests was shown in the analysis of whole tissue, ground, or emulsified raw meat products. Both tests were demonstrated to be reliable and were capable of detecting adulterants present at the 10% level. The method has been adopted official first action.

A poultry rapid overnight field identification test (PROFIT) has been developed as a screening test which is practical, economical, and easy to perform and interpret for use in field environments to determine the presence of poultry tissue (chicken and turkey) in raw whole tissue or ground/formulated meat products. The basis of the test is an agar-gel immunodiffusion technique used with a printed template pattern and stabilized reagent paper discs. The test shows adequate sensitivity and specificity for its intended purpose. Key components are stable for at least 1 year if they are stored at refrigerator conditions. The design of the test is such that it can be made commercially available as a complete, stable, test kit suitable for use by any type of inspection program concerned with verification of poultry species in meat and/or poultry products that are subject to regulatory or quality controls.

A serological ovine field test (SOFT) has been developed for detection of lamb or sheep tissue in a wide variety of raw meat products. The test is an adaptation of previously developed field screening immunodiffusion tests for beef, poultry, and pork detection. The SOFT test was demonstrated to be specific, sensitive, and accurate in the analysis of 104 samples.

A porcine rapid identification method (PRIME) has been developed for detection of pork in a wide variety of meat products. The test is an adaptation of previously developed field screening immunodiffusion tests for beef and poultry detection. The PRIME test was demonstrated to be specific, sensitive, and accurate in the analysis of samples in the laboratory and in a commercial meat processing establishment.

Nine strains of organisms morphologically and physiologically identified as Gaffkya tetragena were obtained from various sources to study their pathogenicity. Initial virulence analysis of all strains by mouse intraperitoneal injection of viable cells revealed that only three strains, recently isolated from and associated with respiratory infections in hospitalized patients, caused death of mice within 48 hr. The ld(50) for these virulent, encapsulated strains was 1 x 10(7) to 6 x 10(7) viable organisms. To associate virulence with a toxic component, the following fractions were purified from all strains: capsular material, cell walls, mucopeptide preparations from cell walls and whole cells, grouplike material, cytoplasmic material, and culture filtrate with and without added reducing agent. Rabbit and mouse dermal toxicity testing of these fractions revealed that the capsular material, cell walls, and mucopeptide preparations of the virulent strains were toxic. None of the nonvirulent strains contained toxic components, with the exception of one strain which yielded capsular material equal in toxicity to that of the virulent strains. The capsular material induced a soft pustular lesion persisting for approximately 22 days. Cell walls and mucopeptide preparations produced a hard nodular lesion, identical to that produced by autoclaved whole cells, that persisted for 25 to 30 days. One strain may represent a virulence intermediate between the virulent and nonvirulent strains, since it contains toxic capsular material but nontoxic cell wall mucopeptide. The results indicate that the virulence of this organism is associated with toxic capsular material and cell wall mucopeptide.