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The photo shows the materials used to perform aspirate punctures of bone marrow: Ethyl alcohol, Betadyne, cotton, adhesive tape, xylocaine 2%, disposable syringes (5 mL for anesthetic infiltration and 20 mL for aspirate puncture of bone marrow), sterile gloves and Osgood-type 25X12 and 30X12 needles with an obliterator
In black, the maximun and minimum parameters of the elements of the neutrophil series. In red, the average value of 100 patients studied. The increased numbers of neutrophil promyelocytes and the percentual deficit of segmented neutrophils are evident.
In black, the maximun and minimum parameters of the erythroblastic series. In red, the average value of 100 patients studied. The increased number of ortho-chromatic erythroblasts are evident.
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The presence of the above alterations lead us to search for protozoary in the bone marrow smears, especially in those cases where there was the diagnostic possibility of Visceral Leishmaniasis. However, even if all these alterations are found in the same suspected case, a diagnosis of Visceral Leishmaniasis cannot be determined until after the Leishmania donovani are actually found. Most of the alterations cited above have been previously described, and can be found in the international medical literature.
Our sincerest thanks to the medical staff and patients of the Infectious and Parasitic Service of Clinical Hospital of the University of São Paulo School of Medicine where most of this data was gathered.
Photo Gallery: The magnifications used were 400X, 630X and 1000X.
About the author: Nivaldo Medeiros, MD Former Director of the Hematology and Cytology Service of the Central Laboratory of the University of São Paulo School of Medicine. Former Assistant Physician of the Department of Clinical Pathology (Hematology Service) at the Cancer Hospital of São Paulo.
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