Excessive bleeding after dental procedures are one of the most frequent complications occurring in patients with hereditary bleeding disorders. In this retrospective study we collected data from 10 years of experience in the oral care of patients with congenital haemorrhagic disorders in three Italian Hemophilia Centers. Between 1993 and 2003, 247 patients with inherited bleeding disorders underwent 534 dental procedures including 133 periodontal treatments, 41 conservative dentistry procedures, 72 endodontic treatments and 288 oral surgery procedures. We recorded 10 bleeding complications (1.9%), most of which occurred in patients with severe/moderate haemophilia A undergoing multiple dental extractions. Thus, our protocol of management of patients with hereditary bleeding tendency undergoing oral treatment or surgery has been shown to be effective in preventing haemorrhagic complications.

The authors evaluated the performance of four modern, commercially available hematology analyzers for imprecision and inaccuracy in determining the leukocyte differential count. The evaluation was performed according to International Committee for Standardization in Haematology protocols and the National Committee for Clinical Laboratory Standards H20-T standard, using the same group of patients simultaneously. Imprecision was very low among all the analyzers for neutrophils and lymphocytes (coefficient of variation maximum = 4.12%), whereas for the other leukocyte populations it tended to increase as their presence percentage decreased. The imprecision of the analyzers was still lower than that of the microscopic method. The correlation with the manual 800 cell count (inaccuracy) was good for neutrophils, lymphocytes, and eosinophils (r = 0.974 to 0.888), less so for monocytes (r = 0.757 to 0.490), whereas it was poor for basophils (r = 0.532 to 0.078).

The diagnostic performance of the haematology analysers, Technicon Hl, Sysmex NE 8000, Coulter STKS and Sequoia Cell Dyn 3000 was determined by comparing their results for automated differential counting with the result obtained for 400 cells by the manual microscopic method. These comparative studies were performed on a group of adults, containing both normal individuals (n = 150) and those affected by various pathologies (n = 113). The number of morphologically false negatives is low for all the systems (from 1.8% for the Cell Dyn 3000 to 6.2% for the NE 8000), while the number of distributionally false negatives was slightly higher (from 4.4% for the Cell Dyn 3000 to 7% for the HI and NE 8000). The morphological flags, though useful for improving the diagnostic performance of the instruments, show a rather modest sensitivity when taken individually: immature granulocytes/bands from 71% for the STKS to 43% for the NE 8000; blasts from 66.6% for the HI to 53.3% for the STKS, atypical lymphocytes from 59% for the HI to 13.6% for the NE 8000; erythroblasts from 42.8% for the STKS to 7% for the NE 8000.

No abstract