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As an example, the detection of features of unexpected hyposplenismmay suggest a congenital absence of the spleen, splenic atrophy, deposition of amyloid in the spleen, infiltration of neoplastic cells (e.g., in leukemia, lymphoma, or carcinoma) in the spleen, previous splenic infarction, or even a splenectomy of which the patient was unaware in each case putting the patient at risk for complications of hyposplenism.
Some laboratories retain all smears that have been reviewed by a laboratory hematologist or pathologist; this can create a storage problem, and it is likely that, increasingly, digital images of important abnormal smears will be stored.
The continuing importance of the blood smear is highlighted by the recent introduction of photographs of blood smears as a regular feature in both the journal Blood and the British Journal of Haematology, by ongoing efforts to develop image-recognition technology for the automated examination of blood smears, and by the development of telehematology to permit the remote interpretation or second opinions of blood smears.
None of these had an effect in the younger subjects, but in older subjects a serum creatinine of more than 106 µM (1.4 mg/d L) and elevated inflammatory markers (ESR 1 mg/d L) were associated with significantly lower mean hemoglobin values.
Older subjects with elevated creatinine and ESR or CRP were thus excluded from our calculations. Overall, the percentage of subjects excluded from the analysis ranged from 10% to 30%, except for black subjects in NHANES, in which the exclusion rate was approximately 50% for older men and 40% for women.
White Americans are a genetic mixture of persons from various parts of Europe and the Middle East.
Data regarding ancestral origin are available in the Scripps Kaiser database but not in NHANES-III, so that direct comparison is not possible.
In practice, such storage is easily achieved if a patient has also had a bone marrow aspirate (since a blood smear should always be stored with an aspirate), but it is harder to achieve if the peripheral blood smear alone has provided the diagnosis.
Individual laboratories should have a mechanism to make possible the retention of such smears or an image derived from them.
Sometimes the blood smear provides the primary or the only evidence of a specific diagnosis, such as myelodysplastic syndrome, leukemia, lymphoma, or hemolytic anemia.Tags: Adult Dating, affair dating, sex dating