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Ferencova N, Visnovcova Z, Ondrejka I, Hrtanek I, Bujnakova I, Kovacova V, Macejova A, Tonhajzerova I. Peripheral Inflammatory Markers in Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder at Adolescent Age. Int J Mol Sci 2023; 24:11710. [PMID: 37511467 PMCID: PMC10380731 DOI: 10.3390/ijms241411710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are associated with immune dysregulation. We aimed to estimate the pro- and anti-inflammatory activity/balance in ASD and ADHD patients at a little-studied adolescent age with respect to sex. We evaluated 20 ASD patients (5 girls, average age: 12.4 ± 1.9 y), 20 ADHD patients (5 girls, average age: 13.4 ± 1.8 y), and 20 age- and gender-matched controls (average age: 13.2 ± 1.9 y). The evaluated parameters included (1) white blood cells (WBCs), neutrophils, monocytes, lymphocytes, platelets, platelet distribution width (PDW), mean platelet volume, and derived ratios, as well as (2) cytokines-interferon-gamma, interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10, tumor necrosis factor-alpha (TNF-α), and derived profiles and ratios. ASD adolescents showed higher levels of WBC, monocytes, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10, macrophages (M)1 profile, and anti-inflammatory profile than the controls, with ASD males showing higher monocytes, IL-6 and IL-10, anti-inflammatory profile, and a lower T-helper (Th)1/Th2+T-regulatory cell ratio than control males. The ADHD adolescents showed higher levels of PDW, IL-1β and IL-6, TNF-α, M1 profile, proinflammatory profile, and pro-/anti-inflammatory ratio than the controls, with ADHD females showing a higher TNF-α and pro-/anti-inflammatory ratio than the control females and ADHD males showing higher levels of IL-1β and IL-6, TNF-α, and M1 profile than the control males. Immune dysregulation appeared to be different for both neurodevelopmental disorders in adolescence.
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Affiliation(s)
- Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Iveta Bujnakova
- Society to Help People with Autism (SPOSA-Turiec), 03601 Martin, Slovakia
| | - Veronika Kovacova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Andrea Macejova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
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Xu B, Zhang Y, Chen G, Feng J, Gan L. Association of mean platelet volume/lymphocyte ratio with inflammation in non-dialysis patients with chronic kidney disease stages 1-4: A retrospective study. Front Immunol 2022; 13:1041356. [PMID: 36466904 PMCID: PMC9716279 DOI: 10.3389/fimmu.2022.1041356] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/03/2022] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE The mean platelet volume/ratio (MPVLR) is recognized as a novel marker of inflammation. We evaluated whether the MPVLR is associated with inflammation in non-dialysis patients with chronic kidney disease (CKD) stages 1-4. METHODS A total of 402 non-dialysis patients with CKD stages 1-4 were included. The indicators of hematological, renal function (urea, serum creatinine [Scr], estimated glomerular filtration rate [eGFR], and urine albumin to creatinine ratio [ACR]) and the markers of inflammation (high-sensitivity C-reactive protein [hsCRP] and fibrinogen [FIB]) were recorded. The MPVLR values at different CKD stages were analyzed. Next, based on the absence (hsCRP level < 5 mg/L) and presence (hsCRP level > 5 mg/L) of inflammation, the patients were categorized, and the differences in indices between the two groups were observed. The patients were divided into two groups based on the median MPVLR value (6.39) at admission. The laboratory indices of patients with CKD were compared. Simultaneously, a correlation analysis was performed to identify the association between the MPVLR and each parameter. A binary logistic regression analysis was performed to test whether the MPVLR was associated independently with the presence of inflammation in non-dialysis patients with CKD. The receiver operating characteristic (ROC) curve was used to analyzed diagnostic performance of the MPVLR in evaluating the inflammation of non-dialysis patients with CKD stages 1-4. RESULTS The MPVLR was higher in patients with CKD stages 3-4 than in those with CKD stages 1 and 2. Significant differences in urea, Scr, eGFR, ACR, lymphocyte (LYM), red blood cell (RBC), hemoglobin (HGB), RBC distribution width (RDW-CV), MPVLR, and FIB values were observed between the groups with and without inflammation. The patients with a higher MPVLR had higher urea, Scr, ACR, WBC, neutrophils (NEU), RDW-CV, platelet distribution width (PDW), mean platelet volume (MPV), and hsCRP values and lower eGFR, LYM, RBC, HGB, and platelet (PLT) values. The MPVLR showed a positive correlation with age, urea, Scr, WBC, NEU, RDW-CV, PDW, MPV, and hsCRP values and a negative correlation with the eGFR, LYM, RBC, HGB, and PLT values. A logistic analysis revealed that the MPVLR was associated independently with the presence of inflammation in non-dialysis patients with CKD, after adjustment for the confounding factors (odds ratio = 1.020; P = 0.024). Furthermore, MPVLR exhibited a modest diagnostic performance for the assessment of inflammation in non-dialysis patients with CKD stages 1-4, with an area under the curve (AUC) of 0.706, and the sensitivity, specificity being 46.2% and 83.2%, respectively. CONCLUSIONS The MPVLR was associated independently with the presence of inflammation in non-dialysis patients with CKD and may be useful for monitoring inflammation.
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Affiliation(s)
| | | | | | | | - Lingling Gan
- Department of Clinical Laboratory, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
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Vélez-Páez JL, Legua P, Vélez-Páez P, Irigoyen E, Andrade H, Jara A, López F, Pérez-Galarza J, Baldeón L. Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis. PLoS One 2022; 17:e0262356. [PMID: 34990467 PMCID: PMC8735631 DOI: 10.1371/journal.pone.0262356] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 12/21/2021] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Sepsis is a public health problem due to its high prevalence and mortality. Mean platelet volume (MPV), a biomarker reported in routine blood counts, has been investigated and shows promise for determining fatal outcomes in septic patients. OBJECTIVE Evaluate whether the mean platelet volume (MPV) and mean platelet volume-to-platelet count (MPV/P) ratio are predictors of clinical severity and mortality in patients with sepsis. METHODS A prospective population cohort of 163 patients aged 18-97 years was recruited at the Intensive Care Unit of Pablo Arturo Hospital, Quito, Ecuador from 2017-2019 and followed up for 28 days. Patients were diagnosed with sepsis based on SEPSIS-3 septic shock criteria; in which the MPV and the MPV/P ratio were measured on days 1, 2, and 3. Sequential organ failure assessment (SOFA) score and presence of septic shock assessed clinical severity. Mortality on day 28 was considered the fatal outcome. RESULTS The average age of the patients was 61,15 years (SD 20,94) and female sex was predominant. MPV cutoff points at days 1, 2 and 3 were >9,45fL, >8,95fL and >8, 85fL; and (MPV/P) ratio >8, 18, >4, 12 y >3, 95, respectively. MPV at days 2 (9,85fL) and 3 (8,55fL) and (MPV/P) ratio at days 1 (4,42), 2 (4,21), and 3 (8,55), were predictors of clinical severity assessed by septic shock, which reached significance in the ROC curves. MPV and (MPV/P) ratio were also predictors of clinical severity determined by SOFA at days 1, 2, and 3, where higher values were observed in non-survivors reaching significance in all categories. MPV and MPV/P ratio at days 1, 2 and 3 were independent predictor factors of mortality using Cox proportional hazards model (HR 2,31; 95% CI 1,36-3,94), (HR 2,11; 95% CI 1,17-3,82), (HR 2,13; 95% CI 1,07-4,21) and (HR 2,38; 95% CI 1,38-4,12), (HR 2,15; 95% CI 1,14-4,06), (HR 4,43; 95% CI, 1,72-11,37) respectively. CONCLUSIONS MPV and the MPV/P ratio are predictors of clinical severity and mortality in sepsis. The MPV and its coefficient are indicators of the biological behavior of platelets in sepsis. They should be considered as a cost-effective and rapidly available tool that guides the treatment.
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Affiliation(s)
- Jorge Luis Vélez-Páez
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
- Centro de Investigación Clínica en Medicina Crítica, Hospital Pablo Arturo Suárez, Quito, Ecuador
| | - Pedro Legua
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Pablo Vélez-Páez
- Centro de Investigación Clínica en Medicina Crítica, Quito, Ecuador
- Unidad de Terapia Intensiva, Hospital General IESS de Ibarra, Imbabura, Ecuador
| | - Estefanía Irigoyen
- Centro de Investigación Clínica en Medicina Crítica, Hospital Pablo Arturo Suárez, Quito, Ecuador
| | - Henry Andrade
- Unidad de Terapia Intensiva, Hospital General IESS de Ibarra, Imbabura, Ecuador
| | - Andrea Jara
- Unidad de Emergencia, Hospital Básico de Machachi, Pichincha, Ecuador
| | - Fernanda López
- Instituto de Posgrado Medicina Crítica y Terapia Intensiva, Universidad Central del Ecuador, Quito, Ecuador
| | - Jorge Pérez-Galarza
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
- Instituto de Investigación en Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Lucy Baldeón
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
- Instituto de Investigación en Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
- * E-mail:
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The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis. Diagnostics (Basel) 2021; 11:diagnostics11101881. [PMID: 34679578 PMCID: PMC8534992 DOI: 10.3390/diagnostics11101881] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 12/28/2022] Open
Abstract
Sepsis represents an important global health burden due to its high mortality and morbidity. The rapid detection of sepsis is crucial in order to prevent adverse outcomes and reduce mortality. However, the diagnosis of sepsis is still challenging and many efforts have been made to identify reliable biomarkers. Unfortunately, many investigated biomarkers have several limitations that do not support their introduction in clinical practice, such as moderate diagnostic and prognostic accuracy, long turn-around time, and high-costs. Complete blood count represents instead a precious test that provides a wealth of information on individual health status. It can guide clinicians to early-identify patients at high risk of developing sepsis and to predict adverse outcomes. It has several advantages, being cheap, easy-to-perform, and available in all wards, from the emergency department to the intensive care unit. Noteworthy, it represents a first-level test and an alteration of its parameters must always be considered within the clinical context, and the eventual suspect of sepsis must be confirmed by more specific investigations. In this review, we describe the usefulness of basic and new complete blood count parameters as diagnostic and prognostic biomarkers of sepsis.
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Vélez PA, Baldeón R L, Vélez-Paez JL. The behavior of Mean Platelet Volume in Sepsis in critical patients with and without sepsis. BIONATURA 2021. [DOI: 10.21931/rb/2021.06.02.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The mean platelet volume is an anatomical biomarker that has shown its usefulness in various cardiovascular and metabolic pathologies; in sepsis, it has been positioning itself as an indicator of mortality, easily accessible and immediately applicable when reported in the routine blood count. This study demonstrates the mean platelet volume's biological behavior in critical patients with sepsis compared with non-septic patients. An observational, longitudinal, prospective, monocentric cohort study was conducted in 250 patients treated at the intensive care unit of the Pablo Arturo Suárez Hospital, Quito- Ecuador, from January 2019 January 2020. A group of patients with sepsis (n = 125) and without infectious pathologies (n = 125) were studied. The inclusion criteria were patients over 18 years of age of both genders, diagnosed with sepsis or septic shock using SEPSIS 3 criteria, and patients without septic pathology. The mean platelet volume (MPV) of days 1, 2, and 3 were studied. Septic patients had a mean APACHE (18.74 SD 9.52) higher than the non-septic ones (11.93 SD 7.01) (p = < 0.000). The MPV was consistently higher in patients with sepsis than non-septic patients, but it reached statistical significance on day 3 (9.13 SD 1.55 vs. 8.66 SD 1.34, p=0.042). The MPV on day 3 presented a significant area under the curve (AUC =0.580) (CI. 0.500-0.661), where the cut-off point according to Youden's index was positive for sepsis if MPV≥ 9.85 femtoliter (fL) with OR=3.30 and p-value= 0.005. Likewise, lactate on admission showed an AUC of 0.625 (CI. 0.555-0.694), with a cut-off point ≥of 1.15 mmol / L, OR=2.51, and p=0.007. Age and hypertension did not show a multivariate relationship with the presence of sepsis. It was shown that MPV is higher in patients with sepsis compared to non-septic ones. This observation reaches significance on day 3. Additionally, elevated lactate at admission was also associated with a septic state. On the other hand, platelet count did not show the expected behavior.
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Affiliation(s)
| | - Lucy Baldeón R
- Facultad de Ciencias Médicas-Universidad Central del Ecuador Instituto de Investigación en Biomedicina Universidad Central del Ecuador
| | - Jorge Luis Vélez-Paez
- Servicio de Medicina Crítica-Hospital Pablo Arturo Suárez Facultad de Ciencias Médicas-Universidad Central del Ecuador
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Atik D, Kaya HB. EVALUATION OF THE RELATIONSHIP OF MPV, RDW AND PVI PARAMETERS WITH DISEASE SEVERITY IN COVID-19 PATIENTS. Acta Clin Croat 2021; 60:103-114. [PMID: 34588729 PMCID: PMC8305345 DOI: 10.20471/acc.2021.60.01.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/15/2021] [Indexed: 01/09/2023] Open
Abstract
Coronavirus was first detected in three severe pneumonia cases in Wuhan, China, in December 2019. Studies on red cell distribution width (RDW-CV) and mean platelet volume (MPV) laboratory parameters, which can be examined in complete blood count in COVID-19 patients, are still very limited. However, to the best of our knowledge, there are no studies examining the relationship between platelet volume index (PVI) and disease severity in COVID-19 patients, which was evaluated in this study. The aim of this study was to evaluate the relationship of disease severity in COVID-19 patients with their MPV, RDW, and PVI parameters. The study included 92 COVID-19 patients as a study group and 84 healthy individuals as control group. All laboratory data and radiological images were scanned retrospectively from patient files and hospital information system. Evaluation of the RDW-CV and MPV blood parameters, and PVI measured in COVID-19 patients yielded statistically significant differences according to the disease severity. We suggest that RDW-CV and PVI, evaluated within the scope of the study, may be the parameters that should be considered in the early diagnosis of the disease, from the initial stages of COVID-19. In addition, we think that the RDW-CV and MPV laboratory parameters, as well as PVI, which all are simple, inexpensive and widely used hematologic tests, can be used as important biomarkers in determining COVID-19 severity and mortality.
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Affiliation(s)
| | - Hasan Burak Kaya
- Department of Emergency Medicine, Yozgat Bozok University, Yozgat, Turkey
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SÖZEN M, ÇETİNASLAN B, CANTÜRK Z, SELEK A, GEZER E, DEMİRHAN Y, CETIN Y. İnflamasyonla İlişkili Hemogram Parametreleri Diyabetes Mellitusun Bir Göstergesi Olabilir Mi? KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.30934/kusbed.757832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bilgin S, Aktas G, Zahid Kocak M, Atak BM, Kurtkulagi O, Duman TT, Savli H. Association between novel inflammatory markers derived from hemogram indices and metabolic parameters in type 2 diabetic men. Aging Male 2020; 23:923-927. [PMID: 31250688 DOI: 10.1080/13685538.2019.1632283] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AIM Hemogram indices were proposed as novel inflammatory markers in chronic conditions and inflammation has substantial role in the pathogenesis of type 2 diabetes mellitus (T2DM). We aimed to observe hemogram parameters of type 2 diabetic male subjects with various age groups in well and poorly controlled subsets. METHODS Data of type 2 diabetic men enrolled to the study were recorded from patient files of the institution. Study population were grouped into three according to the age. Group A was consisted of patients younger than 55 years, Group B was consisted of patients aged between 55 and 64 years, and Group C was consisted of patients aged 65 years or older. Data of the study groups were compared. RESULTS Study population was consisted of 130 subjects; 44 in Group A and 43 in each of Groups B and C. Median red cell distribution width (RDW) (p = .04), mean RDW to platelet ratio (RPR) (p = .006), median mean platelet volume to platelet ratio (MPR) (p = .02) levels of the study groups were statistically different. HbA1c level was significantly and positively correlated with RDW (r = 0.45, p < .001), neutrophil to lymphocyte ratio (NLR) (r = 0.47, p < .001), mean platelet volume to lymphocyte ratio (MLR) (r = 0.35, p < .001), MPR (r = 0.26, p = .003), and RPR (r = 0.37, p < .001) levels. CONCLUSION Elevated RDW, NLR, MLR, MPR, and RPR levels in diabetic men should trigger the measurement of HbA1c since each were strongly correlated with HbA1c level. Moreover, elevated RDW, NLR, MLR, and RPR could be marker of worse diabetic control in men with T2DM.
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Affiliation(s)
- Satilmis Bilgin
- Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey
| | - Gulali Aktas
- Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey
| | - M Zahid Kocak
- Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey
| | - Burcin M Atak
- Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey
| | - Ozge Kurtkulagi
- Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey
| | - Tuba T Duman
- Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey
| | - Haluk Savli
- Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey
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Oktay MM, Boğan M, Çolak ST, Sabak M, Gümüşboğa H, Eren SH. Evaluation of the diagnostic value of platelet indices in pediatric acute appendicitis. J Int Med Res 2020; 48:300060520946515. [PMID: 32962484 PMCID: PMC7521055 DOI: 10.1177/0300060520946515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Abdominal examination findings in pediatric acute appendicitis (AA) significantly vary by age. Therefore, grading systems have been developed for diagnosing pediatric appendicitis, and laboratory and radiological findings have an important role in this diagnosis. However, there is a need to develop new parameters for diagnosing AA. This study aimed to investigate the diagnostic value of platelet indices in AA. METHODS This retrospective, observational study included 207 pediatric patients who were admitted to the Emergency Department and operated on for AA. The patients were divided into three groups on the basis of their surgical and histopathological findings (non-AA, uncomplicated AA, and complicated AA). RESULTS There was no significant difference in the mean platelet volume/platelet count (MPV/PC) ratio among the groups. The white blood cell (WBC) count and the MPV/PC ratio showed a significant negative relationship (r = -0.239). The specificity for MPV was 61.8% and the sensitivity was 68.8%. Receiver operating curve analysis of WBC and MPV showed significance for diagnosing AA. CONCLUSION There is a negative, but weak, relationship between the WBC count and the MPV/PC ratio. However, the MPV/PC ratio could be a useful parameter for diagnosing pediatric AA according to receiver operating curve analysis.
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Affiliation(s)
- M Murat Oktay
- Vocational High School, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Mustafa Boğan
- Emergency Department, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Selcan Türker Çolak
- Pediatric Surgery Department of Şehitkamil State Hospital, Gaziantep, Turkey
| | - Mustafa Sabak
- Emergency Department of Nizip State Hospital, Gaziantep, Turkey
| | - Hasan Gümüşboğa
- Emergency Department of Şehitkamil State Hospital, Gaziantep, Turkey
| | - Sevki Hakan Eren
- Gaziantep University Faculty of Medicine, Department of Emergency Medicine, Gaziantep, Turkey
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Platelet Indices as the Predictor of Antibiotics Response in Surgical Wound Infections Following Total Abdominal Hysterectomy. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 53:132-136. [PMID: 32377071 PMCID: PMC7199835 DOI: 10.14744/semb.2019.46693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/01/2019] [Indexed: 12/04/2022]
Abstract
Objectives: The mean platelet volume (MPV) and the MPV-to-platelet (PLT) count ratio have long been reported as inflammation markers. In this study, we aimed to investigate the predictive value of the MPV and the MPV-to-PLT ratio on surgical wound healing in patients who underwent abdominal hysterectomy and experienced infections at the surgical site following surgery, despite adequate antimicrobial treatment. Methods: A total of 100 patients who encountered surgical wound infection (SWI) after abdominal hysterectomy were enrolled retrospectively. Samples for complete blood count were drawn the day before the operation. All patients received preoperative and postoperative antibiotic prophylaxis and proper antimicrobial treatment following the SWI development. Patients’ condition resolved after standard care and antimicrobial agents were classified as the standard care group. Others, in whom an improvement despite the standard care was not observed, underwent delayed primary closure and were classified as the delayed primary closure group. Results: The PLT count was decreased (319.5±66 103/µL vs. 392±121 103/µL; p<0.05), MPV(9.2±1.3 fL vs. 8.2±1.5 fL; p<0.05), and the MPV-to-PLT ratio (0.030±0.006 vs. 0.024±0.014; p<0.05) was increased in the delayed primary closure group compared to the standard care group. A receiver operating characteristic curve analysis was performed to determine the predictive value of these parameters on the response to standard care measures providing 8.28fL as a cut-off value for MPV (AUC=0.647, 72% sensitivity and 52% specificity) and 0.025 as a cut-off value for the MPV-to-PLT ratio (AUC=0.750, 75% sensitivity and 67% specificity) for predicting nonresponsiveness. Conclusion: An increased preoperative MPV and the MPV-to-PLT ratio may predict poor wound healing following total abdominal hysterectomy.
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Vélez-Paez JL, Velarde-Montero C, Irigoyen-Mogro E, Vélez-Páez P, Cifuentes-López P, Vélez JW, Albitres-Flores L, Barboza JJ. Volumen plaquetario medio como predictor de la mortalidad en pacientes con sepsis: revisión sistemática y metanálisis. INFECTIO 2020. [DOI: 10.22354/in.v24i3.861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introducción: El volumen medio plaquetario (VMP) es un biomarcador utilizado en el abordaje integral de la sepsis. Objetivo: Evaluar la asociación entre VMP con la mortalidad en pacientes con sepsis. Métodos: Se realizó una revisión sistemática de estudios observacionales en cinco bases de datos. Se analizó la mortalidad asociada con la sepsis; las intervenciones consideradas fueron VMP, APACHE y lactato sérico. Resultados: Respecto a la mortalidad asociada a sepsis, se encontró un valor significativo en la VMP a las 72 horas (200 fallecidos versus 654 no fallecidos; MD 0.83 IC95% 0.53-1.13, p= <0.0001, I2=72.9%); así como el valor de APACHE II (220 muertos frente a 604 no fallecidos; MD 0.81 IC95% 0.62-1.0, p= <0.0001, I2=32%). No se encontró significancia estadística para las demás variables clínicas. Conclusiones: El aumento de la VMP se asocia con mayor riesgo de mortalidad en pacientes con sepsis, especialmente después de 72 horas de evolución de las características clínicas.
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Acharya AB, Shetty IP, Jain S, Padakannaya I, Acharya S, Shettar L, Thakur S. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in chronic periodontitis before and after nonsurgical therapy. J Indian Soc Periodontol 2019; 23:419-423. [PMID: 31543614 PMCID: PMC6737853 DOI: 10.4103/jisp.jisp_622_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Various biomarkers have been evaluated for understanding the systemic inflammatory response (SIR) to periodontitis. Hematological markers have been reported to be useful biomarkers in a variety of diseases, including periodontal diseases. The role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in periodontitis and their possible role in the SIR are not extensively documented. Therefore, this study assessed NLR and PLR in chronic periodontitis (CP) patients before and after periodontal treatment, which to the best of knowledge has not been reported in the literature. Materials and Methods: Sixty participants were grouped as systemically and periodontally healthy (H) (n = 30) and with CP (n = 30). Plaque index, gingival index, probing pocket depth, clinical attachment loss, leukocyte counts, platelet (PLT) counts, NLR, and PLR were estimated at baseline and also after treatment in the CP group. NLR was calculated as total neutrophil count/absolute lymphocyte count, and PLR was calculated as total PLT count/absolute lymphocyte count. The data were statistically analyzed. Results: Periodontal parameters differed significantly between groups H and CP at baseline and posttreatment. A pair-wise comparison of NLR and PLR between CP patients at baseline and posttreatment was significant. Correlation analyses were not remarkable. Receiver operating characteristics analyses provided significant NLR and PLR predictive cutoff values to differentiate between CP patients at baseline and posttreatment. Conclusion: NLR and PLR may serve as potential biomarkers of the SIR to CP to bridge the association between periodontal and systemic conditions.
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Affiliation(s)
- Anirudh Balakrishna Acharya
- Department of Periodontics, S.D.M. College of Dental Sciences and Hospital, SDM University, Dharwad, Karnataka, India
| | | | - Shrinidhi Jain
- Department of Periodontics, S.D.M. College of Dental Sciences and Hospital, SDM University, Dharwad, Karnataka, India
| | | | - Swetha Acharya
- Department of Oral Pathology and Microbiology, S.D.M. College of Dental Sciences and Hospital, SDM University, Dharwad, Karnataka, India
| | - Leena Shettar
- Department of Periodontics, S.D.M. College of Dental Sciences and Hospital, SDM University, Dharwad, Karnataka, India
| | - Srinath Thakur
- Department of Periodontics, S.D.M. College of Dental Sciences and Hospital, SDM University, Dharwad, Karnataka, India
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Early Blood Biomarkers to Improve Sepsis/Bacteremia Diagnostics in Pediatric Emergency Settings. ACTA ACUST UNITED AC 2019; 55:medicina55040099. [PMID: 30974881 PMCID: PMC6524067 DOI: 10.3390/medicina55040099] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/13/2019] [Accepted: 04/04/2019] [Indexed: 02/07/2023]
Abstract
Background: Sepsis is the leading cause of death in children worldwide. Early recognition and treatment are essential for preventing progression to lethal outcomes. CRP and Complete Blood Count (CBC) are the initial preferred tests to distinguish between bacterial and viral infections. Specific early diagnostic markers are still missing. Aim: To investigate diagnostic value of Neutrophil-Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV) and Platelet-MPV ratio (PLT/MPV) to distinguish sepsis/bacteremia and viral infection. Methods: We conducted a retrospective data analysis of case records of 115 children from 1 month to 5 years of age. All cases were divided into two groups-sepsis/bacteremia (n = 68) and viral (n = 47) patients, and further subdivided according to the time of arrival into early or late (≤12 or 12-48 h post the onset of fever, respectively). Analysis of CBC and CRP results was performed. NLR and PLT/MPV were calculated. Results: Sepsis/bacteremia group demonstrated higher absolute platelets count (370.15 ± 134.65 × 10⁸/L versus 288.91 ± 107.14 × 10⁸/L; p = 0.001), NLR (2.69 ± 2.03 versus 1.83 ± 1.70; p = 0.006), and PLT/MPV (41.42 ± 15.86 versus 33.45 ± 17.97; p = 0.001). PLT/MPV was increased in early arrival sepsis/bacteremia infants (42.70 ± 8.57 versus 31.01 ± 8.21; p = 0.008). NLR and MPV were significantly lower in infants (≤12 months) with viral infection on late arrival (1.16 ± 1.06 versus 1.90 ± 1.25, p = 0.025 for NLR and 8.94 ± 0.95fl versus 9.44 ± 0.85fl, p = 0.046 for MPV). Conclusion: Together with standard blood biomarkers, such as CRP, neutrophils, or platelets count, PLT/MPV is a promising biomarker for clinical practice to help discriminate between viral disease or sepsis/bacteremia in all children, especially in early onset of symptoms. NLR and MPV could support exclusion of sepsis/bacteremia in late arrival cases.
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14
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Yuan C, Hou J, Zhou Y, Hu C, Sun H, Chen W, Yuan J. Dose-response relationships between polycyclic aromatic hydrocarbons exposure and platelet indices. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 245:183-198. [PMID: 30419459 DOI: 10.1016/j.envpol.2018.10.127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
The relations of polycyclic aromatic hydrocarbons (PAHs) exposure with platelet indices remain unclear. Based on the baseline data from the Wuhan-Zhuhai Cohort Study, we used generalized linear model, multivariate logistic regression analysis and restricted cubic splines (RCS) to assess linear and nonlinear relationship of PAHs exposure with platelet indices. The results showed that among Wuhan individuals, there were the non-linear relations between total hydroxynaphthalene (ΣOHNa) and mean platelet volume (MPV) or ratio of mean platelet volume to platelet count (MPVP), total hydrophenanthrene (ΣOHPh) and MPV or platelet distribution width (PDW), the sum concentration of urinary monohydroxylated metabolites of PAHs (ΣOH-PAHs) and ratio of platelet count to lymphocyte count (PLR) or MPVP, 1-hydropyrene (1-OHP) and PLR or PDW. But among Zhuhai individuals, neither linear nor non-linear relations were found between each of OH-PAHs or ΣOH-PAHs and platelet indices. The findings indicate that serum MPV and MPVP may be independent biomarkers of effects of exposing to environmental PAHs on human bodies.
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Affiliation(s)
- Chunjie Yuan
- Department of Occupational and Environmental Health, Hangkong Road 13, Wuhan, 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei, PR China
| | - Jian Hou
- Department of Occupational and Environmental Health, Hangkong Road 13, Wuhan, 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei, PR China
| | - Yun Zhou
- Department of Occupational and Environmental Health, Hangkong Road 13, Wuhan, 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei, PR China
| | - Chen Hu
- Department of Occupational and Environmental Health, Hangkong Road 13, Wuhan, 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei, PR China
| | - Huizhen Sun
- Department of Occupational and Environmental Health, Hangkong Road 13, Wuhan, 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei, PR China
| | - Weihong Chen
- Department of Occupational and Environmental Health, Hangkong Road 13, Wuhan, 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei, PR China
| | - Jing Yuan
- Department of Occupational and Environmental Health, Hangkong Road 13, Wuhan, 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, 430030, Hubei, PR China.
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15
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Cotoia A, Franchi F, De Fazio C, Vincent JL, Creteur J, Taccone FS. Platelet indices and outcome after cardiac arrest. BMC Emerg Med 2018; 18:31. [PMID: 30253749 PMCID: PMC6157054 DOI: 10.1186/s12873-018-0183-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/18/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Platelet variables, including platelet distribution width (PDW) and mean platelet volume (MPV), have been associated with outcome in critically ill patients. We evaluated these variables in patients after cardiac arrest (CA). METHODS All adult CA patients admitted to the intensive care unit (ICU) over an 8-year period (2006-2014) and treated with targeted temperature management were included. We retrieved all data concerning CA characteristics as well as platelet count, PDW and MPV on the first 2 days of admission. Unfavorable 3-month neurological outcome was defined as a cerebral performance category score of 3-5. RESULTS We included 384 patients (age 62 [52-75] years; 270/384 male): 231 patients (60%) died within 30-days and 246 patients (64%) had an unfavorable 3-month neurological outcome. On admission, platelet count, PDW and MPV were 87 [126-261] *103cells/mm3, 17 [16.3-17.3]% and 8.3 [7.6-9.2] μm3, respectively. Platelet count decreased significantly over the first 2 days, whereas PDW and MPV did not change significantly. There were no significant differences between the values on admission or time-courses of platelet count, PDW or MPV between survivors and non-survivors or between patients with unfavorable and favorable neurological outcome. CONCLUSIONS In our cohort of post-CA patients, PDW and MPV were not associated with outcome.
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Affiliation(s)
- Antonella Cotoia
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium.,Department of Anaesthesiology and Intensive Care, University of Foggia, Foggia, Italy
| | - Federico Franchi
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Chiara De Fazio
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Jean-Louis Vincent
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Jacques Creteur
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Fabio Silvio Taccone
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium.
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16
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Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacteremia? Mediators Inflamm 2018; 2018:3758068. [PMID: 30116146 PMCID: PMC6079471 DOI: 10.1155/2018/3758068] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/27/2018] [Accepted: 05/14/2018] [Indexed: 12/13/2022] Open
Abstract
Background Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet count (MPV/PC) ratio are readily available parameters that might have discriminative power regarding outcome. The aim of our study was to assess prognostic value of these biomarkers regarding outcome in critically ill patients with secondary sepsis and/or trauma. Methods A total of 392 critically ill and injured patients, admitted to surgical ICU, were enrolled in a prospective observational study. Leukocyte and platelet counts were recorded upon fulfilling Sepsis-3 criteria and for traumatized Injury Severity Score > 25 points. Patients were divided into four subgroups: peritonitis, pancreatitis, trauma with sepsis, and trauma without sepsis. Results NLR and MPV/PC levels were significantly higher in nonsurvivors (AUC/ROC of 0.681 and 0.592, resp., in the peritonitis subgroup; 0.717 and 0.753, resp., in the pancreatitis subgroup); MLR and PLR did not differ significantly. There was no significant difference of investigated biomarkers between survivors and nonsurvivors in trauma patients with and without sepsis except for PLR in the trauma without sepsis subgroup (significantly higher in nonsurvivors, AUC/ROC of 0.719). Independent predictor of lethal outcome was NLR in the whole cohort and in the peritonitis subgroup as well as MPV in the pancreatitis subgroup. Also, there were statistically significant differences in MPV/PC, MLR, and PLR values regarding nature of bacteremia. In general, the lowest levels had been found in patients with Gram-positive blood cultures. Conclusions NLR and MPV were very good independent predictors of lethal outcome. For the first time, we demonstrate that nature of bacteremia influences MPV/PC, MLR, and PLR. In heterogeneous cohort subgroup, analysis is essential.
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17
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Dursun A, Ozsoylu S, Akyildiz BN. Neutrophil-to-lymphocyte ratio and mean platelet volume can be useful markers to predict sepsis in children. Pak J Med Sci 2018; 34:918-922. [PMID: 30190753 PMCID: PMC6115542 DOI: 10.12669/pjms.344.14547] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives Neutrophil-to-Lymphocyte Ratio (NLR) and Mean Platelet Volume (MPV) have been found to be useful indexes for the diagnosis of sepsis in adults. However, the knowledge of their roles and cut-off values in pediatric patients is limited. The primary objective of this study was to assess the ability of NLR and MPV to predict sepsis in children. A secondary aim was to evaluate the comparison of these parameters with C-reactive Protein (CRP). Methods The study was conducted on pediatric patients, who had two or more of the following criteria were included in the study: tachycardia, tachypnea, temperature change, leukocytosis, or leukopenia for age. Patients were classified into sepsis and non-sepsis groups. The sepsis group was defined as the presence of two or more age specific Systemic Inflammatory Response Syndrome (SIRS) criteria and increased Procalcitonin (PCT) level (>0.5 ng/ml). Result The median age of the study population was 18 (6-169) months. Two hundred-sixty four episodes of sepsis were recorded in 125 patients. Eighty two were classified as sepsis and 182 as non-sepsis. CRP level and MPV value were significantly higher in the sepsis group compared to non-sepsis group. The median CRP level was 47.8 mg/dl (10.2-119.5) in the sepsis group and 18.6 mg/dl (4.9-66.1) in the non-sepsis group (p=0.006). In the sepsis group, the median MPV value was 8.4 (7.6-9.5) and it was 7.8 (7.1-8.5) in the non-sepsis group (p=0.001). Significant correlations were found between the procalcitonin (PCT) and CRP level (p<0.001; r = 0.279), NLR (p=0.02; r = 0.186) and MPV (p<0.001; r = 0.243). MPV had the highest specificity for predicting sepsis (75.8%). The largest AUC was 0.629 with a cut-off value 8.5 for MPV, while the AUC was 0.557 with a cut-off value 1.97 for NLR and 0.606 with a cut-off value 38.9 for CRP. Conclusions NLR and MPV values should alert clinicians to the possibility of sepsis and to initiate or change antibiotic treatment.
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Affiliation(s)
- Adem Dursun
- Adem Dursun, MD. Department of Paediatrics, Division of Intensive Care, Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | - Serkan Ozsoylu
- Serkan Ozsoylu, MD. Department of Paediatrics, Division of Intensive Care, Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | - Basak Nur Akyildiz
- Basak Nur Akyildiz, MD. Associate Professor of Paediatrics, Department of Paediatrics, Division of Intensive Care, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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18
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Biricik S, Narcı H, Dündar GA, Ayrık C, Türkmenoğlu MÖ. Mean platelet volume and the ratio of mean platelet volume to platelet count in the diagnosis of acute appendicitis. Am J Emerg Med 2018; 37:411-414. [PMID: 29866415 DOI: 10.1016/j.ajem.2018.05.075] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Mean platelet volume (MPV) is an inflammatory marker. Recent studies have shown that there is a negative correlation between platelet count (PC) and MPV and that the ratio of these two values may be more meaningful. The aim of our study was to investigate the diagnostic value of MPV and the MPV/PC ratio in acute appendicitis. METHODS Patients who were admitted to the emergency department and underwent appendectomy for acute appendicitis between January 2013 and May 2016 were evaluated retrospectively. The patients were divided into three groups based on their histopathological findings: the control group (negative appendicectomy) and the uncomplicated and complicated appendicitis groups. Leukocyte count, CRP (C-reactive protein) levels, PC, MPV and the MPV/PC ratio were compared among the groups. RESULTS A total of 424 patients, including 231 men, were included in the study. The average age of all patients was 34.9 ± 13.2 years. There was no statistically significant difference between the uncomplicated appendicitis, complicated appendicitis and control groups in terms of MPV, PC and the MPV/PC ratio. Leukocyte count had a strong discriminatory property based on the area under curve (AUC) 0.73, (p < 0.001). CRP levels, MPV, PC and the MPV/PC ratio had weak discriminatory power with AUC values <0.65. Using receiver operating characteristic (ROC) analysis, the sensitivity and specificity of MPV were 83.79% and 23.21%, respectively, and 66.48% and 48.21%, respectively, for the MPV/PC ratio. CONCLUSIONS In our study, MPV and the MPV/PC ratio were not useful in the diagnosis of acute appendicitis.
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Affiliation(s)
- Serdar Biricik
- Mersin University, Faculty of Medicine, Department of Emergency Medicine, Turkey
| | - Hüseyin Narcı
- Mersin University, Faculty of Medicine, Department of Emergency Medicine, Turkey.
| | | | - Cüneyt Ayrık
- Mersin University, Faculty of Medicine, Department of Emergency Medicine, Turkey
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Montero-Chacón LB, Padilla-Cuadra JI, Chiou SH, Torrealba-Acosta G. High-Density Lipoprotein, Mean Platelet Volume, and Uric Acid as Biomarkers for Outcomes in Patients With Sepsis: An Observational Study. J Intensive Care Med 2018; 35:636-642. [PMID: 29720052 DOI: 10.1177/0885066618772825] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND We conducted an observational study evaluating the association between uric acid, mean platelet volume (MPV), and high-density lipoprotein (HDL) with complications and outcomes of patients with sepsis in a critical care setting. METHODS We followed patients with a diagnosis of severe sepsis and septic shock for a maximum of 28 days. Main outcomes assessed included length of stay (LOS), the need for renal replacement therapy (RRT), assisted mechanical ventilation (AMV), and vasopressor support as well as in-unit mortality. RESULTS The overall average age of the 37 patients enrolled was 48.1 (19.8) years; among them, 37.8% were male. Abdominal related (43.2%) and pulmonary (29.7%) were the main sites of infection. The overall Acute Physiology and Chronic Health Evaluation 2 (APACHE-2) median score was 19 (9-24). Acute kidney injury (AKI) was observed in 46.9% of the sample. In all, 54.1% required vasopressor support, 54.1% AMV, and 35.1% RRT. Patients with bacteremia were significantly more likely to require vasopressor support and those with urinary tract infections were significantly younger. We found increasing ΔMPV levels, higher APACHE-2 scores, lower HDL values, and a reduced age to be associated with a longer LOS. Higher scores on the APACHE-2 scale and lower levels of HDL significantly associated with higher odds for developing AKI. The need for vasopressor support was significantly associated with higher values of 72-hour MPV and with higher levels of baseline uric acid and lower values of initial HCO3. Initial and 72-hour levels of MPV and higher scores in the APACHE-2 were all significantly correlated with the need for AMV. An increased probability of dying during follow-up was significantly correlated with increasing age. CONCLUSION We were able to establish significant associations between our candidate biomarkers and relevant outcomes for patients with sepsis. Our results support the use of these low-cost biomarkers in the assessment of prognosis of patients with sepsis.
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Affiliation(s)
| | - Juan Ignacio Padilla-Cuadra
- Neurocritical Care Unit, Department of Neurosciences, Hospital Rafael Ángel Calderón Guardia, Caja Costarricense de Seguro Social, San José, Costa Rica
| | - Sy Han Chiou
- Department of Mathematical Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Gabriel Torrealba-Acosta
- Division of Neurology, Department of Internal Medicine, Hospital Rafael Ángel Calderón Guardia, Caja Costarricense de Seguro Social, San José, Costa Rica.,Neurosciences Research Center, University of Costa Rica, San José, Costa Rica
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20
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Vukicevic P, Mikic A, Kotur-Stevuljevic J, Bogavac-Stanojevic N, Milic N, Nikolic L, Martinovic J. Oxidative stress and platelet activation during on-pump and off-pump coronary artery bypass grafting in patients with double grafted vessels. BIOTECHNOL BIOTEC EQ 2016. [DOI: 10.1080/13102818.2016.1217168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Petar Vukicevic
- Department for Cardiac Surgery, Military Medical Academy , Belgrade, Serbia
| | - Aleksandar Mikic
- Clinic for Cardiac Surgery, UC Clinical Centre , Belgrade, Serbia
- Department of Surgery with Anesthesiology, Faculty of Medicine, University of Belgrade , Belgrade, Serbia
| | - Jelena Kotur-Stevuljevic
- Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade , Belgrade, Serbia
| | | | - Natasa Milic
- Department of Surgery with Anesthesiology, Faculty of Medicine, University of Belgrade , Belgrade, Serbia
- Department for Medical Statistics and Informatics , Belgrade, Serbia
| | - Ljubinka Nikolic
- Department for Hematology and Transfusion Laboratory, Clinic for Gynecology and Obstetrics, UC Clinical Centre , Belgrade, Serbia
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Balta S, Aparci M, Ozturk C, Demir M, Yildirim AO, Celik T. Mean platelet volume as one part of platelet function determining inflammation. Ann Saudi Med 2016; 36:234. [PMID: 27236398 PMCID: PMC6074541 DOI: 10.5144/0256-4947.2016.234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Sevket Balta
- Dr. Sevket Balta, Department of Cardiology, Gulhane Medical Faculty, Ankara 066610, Turkey T: +90-312-3044281; F: +90-312-3044250
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