Tutorial on Neutropenia from Dr. Dale

“White blood cells (WBCs) in our body help fight infections. There are various types of WBCs and each has its own way of fighting microbial infections. The most important WBC is called the neutrophil.

“The number of neutrophils in the blood is expressed as absolute neutrophil count (ANC) and it measures the percentage of neutrophils in the differential WBC count. The ANC of a healthy individual falls in the range of 2,500 to 6,000 per microliter.

“A total blood count gives the levels of the three types of blood cells – white blood cells, red blood cells, and platelets. Neutrophils are present in two forms – polys and bands. Polys are also known as segmented neutrophils and are the most abundant of the WBCs. Bands are also called stabs and are immature polys. Both polys and bands destroy invaders (i.e. microbes) in the body.”

Learn more:

Absolute Neutrophil Count (ANC)

Prevalence and clinical significance of neutropenia discovered in routine complete blood cell counts: a longitudinal study

IMG_3349In a study by C. L. Andersen, et. al, published in the Journal of Internal Medicine, it was revealed that with regard to neutropenia :

  1. Neutropenia, defined as an absolute blood neutrophil count (ANC) <1.5 G L, may accompany a variety of diseases. However, the clinical significance of neutropenia detected in a routine complete blood cell count is poorly understood.
  2. Using a primary care resource, comprising more than 370 000 individuals, we assessed the association with a number of previously recognized conditions as well as all-cause mortality in the 4 years following the identification of neutropenia. By matching laboratory data with Danish nation-wide health registers, risk estimates were assessed.
  3. Neutropenia was observed in approximately 1% of all individuals and was associated dose dependently with viral infections, haematological malignancies (but not autoimmune disorders or solid cancers) and mortality.

The conclusion was that:

The lower the ANC, the greater the likelihood of these diseases. The relative risk estimates observed for severe neutropenia corresponded to absolute risks of haematological malignancies and mortality from any cause of 40% and >50%, respectively.

In other words, a low ANC cannot be ignored, and requires thorough investigation until the underlying condition causing the low ANC is determined and addressed.

Read More:

Clinical Significance of Neutropenia in Routine Complete Blood Cell Counts

Washington DC Area: Child Porn and Abuse Capital of the US

The prevalence of child abuse and using children in porn videos in the United States is of epidemic proportions.   This abuse is coming from people who are close to the children, not strangers.  Fathers, doctors, teachers, school aides, police, etc. all have been involved of instances of abuse and child porn production — not only violating basic decency, but also a child’s trust in those who they should be able to trust.  Almost every day, there is another case of such abuse revealed.  Two cases came to light in just the past few days.

In the first case, a school side, a 22-year-old man, was arrested after he allegedly filmed children performing sex acts on each other at a Maryland elementary school, police say.   Deonte Carraway allegedly “videotaped sexual acts between minors during the school day” at Judge Sylvania Woods Elementary School in Glenarden, where he was a volunteer teacher’s assistant, the Prince George’s County Police Department said in a news release.  A relative of one of the victims found a nude photo on the child’s cell phone that was sent to Carraway through a social messaging app, according to the news release.  Investigators have identified at least ten victims ranging in age from 9 to 13, according to the news release. Carraway is believed to have “targeted the victims,” the document adds.

Police say they have uncovered 40 videos showing the young children performing sexual acts on each other or alone at the direction of Carraway. He is also believed to have sexually abused some of the children, according to the news release.  The alleged videos were filmed at the school, a municipal center, aquatic center, and in private homes, police say.   Carraway allegedly admitted to his involvement in manufacturing and producing the child pornography, according to the news release. He was charged with ten counts of child pornography, sexual abuse of a minor, and a second-degree sexual offense.

In the second case,  social workers were sent to a home to investigate the man, a licensed foster parent who was later found to be involved with one of the worst child pornography rings. He lived in a two-bedroom house with two adopted sons, a preteen boy for whom he was seeking guardianship, and a neighborhood teenager who had moved in after an argument with his parents.  When questioned, the children denied the abuse. But the tipster, it seemed, had been at least half right. Searching the man’s computer, social workers found two photos of children, unrelated to the parent, posing in their underwear. The pictures had been taken by one of the foster parent’s friends, one of the boys said. Sometimes they spent time with that friend, the boy said.   To these social workers, these underwear pictures were concerning, but they were not concerning enough. Social workers classified the investigation as “inconclusive,” then closed their inquiry, according to Riverside County court documents.  The boys were left in the man’s home. His foster license was left intact.  

Today, that same parent, John David Yoder, sits behind bars, a suspect in what officials have called one of the worst child pornography rings in Southern California in recent years. Yoder and three other suspects have been accused of victimizing as many as 15 children in Desert Hot Springs, including some of the boys that lived with him. Yoder was arrested in February as result of a separate investigation by law enforcement in Nevada. The charges he now faces are nearly identical to the allegations that were reported to the Riverside County Department of Public Social Services shortly before Christmas.  If social workers had acted differently in December, the boys in Yoder’s home could have been rescued six weeks earlier.

Like in Ariana-Leilani’s case, government officials are notorious for ignoring signs of abuse and neglect.

Please sign the petition to Save Washington DC Resident Ariana-Leilani.

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Prevalence and clinical significance of neutropenia discovered in routine complete blood cell counts: a longitudinal study

Neutropenia, defined as an absolute blood neutrophil count (ANC) <1.5 G L−1, may accompany a variety of diseases. However, the clinical significance of neutropenia detected in a routine complete blood cell count is poorly understood. Neutropenia is associated with viral infections and hematological malignancies in a dose-dependent manner, according to a study published online Jan. 21 in the Journal of Internal Medicine.

C.L. Andersen, from the University of Copenhagen in Denmark, and colleagues examined the clinical significance of neutropenia. A primary care resource was used to examine the correlation with various conditions and all-cause mortality in the four years following neutropenia identification for more than 370,000 individuals.

Neutropenia was observed in approximately 1% of all individuals and was associated dose dependently with viral infections, haematological malignancies (but not autoimmune disorders or solid cancers) and mortality. Neutropenia was particularly associated with HIV, acute leukaemias and myelodysplastic syndromes. Odds ratios [95% confidence interval (CI)] for viral infections were 2.32 (1.84–2.91), 2.80 (2.20–3.57) and 4.77 (3.22–7.07) for subnormal (≥1.5–1.8 G L−1), mild (≥1.0–1.5 G L−1) and moderate–severe (≥0.0–1.0 G L−1) neutropenic individuals, respectively (all P < 0.001). Likewise, odds ratios (95% CI) for haematological malignancies were 3.23 (2.35–4.45), 8.69 (6.58–11.47) and 46.03 (33.98–62.35 ), for the same neutropenia levels, respectively (all P < 0.001). Thus, the lower the ANC, the greater the likelihood of these diseases. The relative risk estimates observed for severe neutropenia corresponded to absolute risks of haematological malignancies and mortality from any cause of 40% and >50%, respectively.

Neutropenia is an ominous sign necessitating careful follow-up. The risk estimates presented support focusing attention to viral diseases and haematological malignancies when neutropenia is observed.  “The risk estimates presented here support focusing attention to viral diseases and hematological malignancies when neutropenia is observed,” the authors write.

Read full text of article: http://onlinelibrary.wiley.com/doi/10.1111/joim.12467/abstract

Authors of the study were:  C. L. Andersen, D. Tesfa, V. D. Siersma, H. Sandholdt, H. Hasselbalch, O. W. Bjerrum, P. Felding, B. Lind, Niels de. F. Olivarius andJ. Palmblad,

Mayor Bowser and Chief Lanier: Take Some Action to Save Ariana-Leilani and Other Children in DC

Distinguished columnist Colby King writes that action needs to be taken now on the epidemic of child prostitution and trafficking in the District of Columbia:

“Human trafficking is a cruel and inhumane practice found in countries around the world. So it should come as no surprise that President Obama proclaimed this month National Slavery and Human Trafficking Prevention Month.

“The exploitation and coercion of girls and young women into prostitution, however, is not limited to places overseas.

“Right here in the nation’s capital, our most vulnerable residents — children — are subjected to sex slavery. Their stories don’t make the evening news or even warrant blurbs in your morning paper. But human trafficking is, and has been, a shadowy and seamy part of D.C. life….

….

U.S. attorney spokesman Bill Miller told me this week, “Since 2009, about 70 defendants have been prosecuted in [federal and D.C. courts] on charges related to human trafficking . . . including abducting or enticing a child into prostitution.”

“The overwhelming majority of those cases” he added, “resulted in convictions.”

“The U.S. attorney’s office has a large task force and an active outreach program on human trafficking, and is urgently scheduling training sessions with D.C. police and schools. Seven churches are joining the Faith Coalition Against Sex Trafficking in our Nation’s Capital to sponsor a meeting Jan. 30.

“They can’t do it alone.

“Let’s help the president and the prosecutors: Human trafficking is in our region, in the nation’s capital, in your ward, on your block.

“Open your eyes. Don’t look abroad. Look down the street.”

Read more:  Colby King on Child Trafficking in DC

Please sign the petition to Save DC Resident Ariana-Leilani.

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