The picture of inflammation: a new concept that combines the white blood cell count and erythrocyte sedimentation rate into a new hematologic diagnostic modality.
BACKGROUND
Physicians who work in small clinics, far away from medical centers, cannot obtain relevant information regarding the acute phase response at low cost and real time.


METHODS
We adopted a simple slide test and image analysis to determine the number of white blood cells in the peripheral blood, their degree of adhesiveness/aggregation as well as that of the red blood cells. Three independent observers scored the images into categories of no (1), mild (2), moderate (3) or severe (4) inflammation.


RESULTS
A substantial interobserver agreement was noted for all three observers. No patient classified as having no (1) inflammation was given a score of moderate (3) or severe (4) inflammation and vice versa. The one-way analysis of variance (age- and gender-adjusted) confirmed that the data obtained from the image analyzer are significantly different between the above-mentioned four categories.


CONCLUSIONS
It is possible to use a simple slide test and image analysis to discriminate effectively between various degrees of inflammation intensity. Since it is possible to send the pictures via telephone, Inter- or Intranet to a physician somewhere else, it might be attractive for medical personnel who work in small clinics not equipped with sophisticated laboratory facilities. This technique is currently being evaluated for possible Telemedicine and E-Health uses.
Rotstein
R
R
Department of Internal Medicine D, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Fusman
R
R
Zeltser
D
D
Shapira
I
I
Shabtai
E
E
Avitzour
D
D
Sadees
N
N
Levartovsky
D
D
Arber
N
N
Eldor
A
A
Berliner
S
S
D000210:Acute-Phase Reaction / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000097:blood; D001424:Bacterial Infections / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002448:Cell Adhesion; D002449:Cell Aggregation; D048429:Cell Size; D005240:Feasibility Studies; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007249:Inflammation / Q000097:blood* / Q000175:diagnosis; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000097:blood; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D017216:Telemedicine; D014657:Vasculitis / Q000097:blood; D014777:Virus Diseases / Q000097:blood
D005340:Fibrinogen; D002097:C-Reactive Protein