chknowle

Are you aware of any other specific tests that can be used to diagnose nonasthmatic eosinophilic bronchitis? This is what the physician is wanting to use the eosinophil count for. I have spent alot of time doing literature reviews and have not found an alternate test(s) to recommend to her. Any help would be appreciated.

We have an XN-3000 that was installed in Feb 2013. It replaced a Sysmex XE-2100 and XT-2000i. We have had excellent experiences with all of our Sysmex analyzers, and we are very happy with the XN-3000. And prior to the XE-2100, we had been exclusively a Beckman/Coulter lab, so we were a hard sell. I don't think Sysmex will disappoint you, and you should not have a difficult transition going from Beckman to Sysmex. Also, Sysmex has provided us with outstanding customer service (both sales and service). Just no complaints from any angle for us. Hope you have the same experience in your lab.

Our new pulmonologist has asked that we start performing quantitatvie sputum eosinophil counts. I am having difficulty finding references to put together a written procedure. One article she shared suggested performing a 400 cell diff to report % eosinophils (ug!). Anyone else performing them, and if you are performing quantitative measurements, how many cells do you count? Also, do you filter the sample through mesh gauze before preparing the smear?

Our lab is evaluating our process for expensive referral tests. I am told that some labs require medical director review for medical neccesity, but am wonder whether this is really happening, and how it works. Does anyone have any policies or practices they can share regarding the handling of high-dollar send out tests (like $400 or more)? Anyone require pre-approval or pre-payment?

Does anyone have any suggestions on how to perform a sperm count on a highly viscous semen sample? We have encountered two like this recently, and ended up resulting them as "unable to perform due to viscosity" (the doc wasn't happy). The sample was so thick we couldn't even pipette it to make a dilution. Could hyalunronidase be used, or would it damage/destroy the sperm? Can't find any help in the WHO guidelines...

We currently perform automated retic counts on our Sysmex XE-2100 and XT-2000i analyzers. We also have the capability of performing manual retic counts (methylene blue stain) as a backup method, but are considering dropping it. Do other Sysmex users out there have backup methods for their automated RC for situations where instruments retic flags are generated that do not resolve with sample dilution? We also do a peripheral slide review on every retic count for interfering substances (HJ bodies, basophilic stippling, etc) since this is a requirement in the latest CAP checklist...

Our policy for manual hemacytometer counts states that the count from the two sides of the hemacytometer must agree within 10%, or the count must be repeated. However, if the count is very low (i.e. a clean CSF), it may be very difficult to get 10% agreement (e.g. side one has 2 WBCs, side two has 1 WBC- this is a 50% difference, but not clinically significant). How do other labs define their agreement criteria on samples with low counts?

For those who perform semen analysis for fertility work-ups, do you reject a sample if it is outside your defined acceptable temperature range, or do you perform the testing and note the deviation on the report?