Changes In Mean Platelet Volume Research Articles

LIVER ENZYME ALTERATIONS AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN A TERTIARY CARE CENTER

Objective: Cholelithiasis is a prevalent global health concern, with laparoscopic cholecystectomy (LC) emerging as the preferred surgical intervention. While LC offers an advantage such as shorter hospital stays, it poses potential risks, including cardiovascular impediments because of hemodynamic and ventilatory changes. The current research study was done to assess the impact of LC on hematological parameters, comparing pre-operative and post-operative levels. Methods: The study comprised 51 subjects undertaking LC, and preoperative and postoperative blood samples were analyzed for various hematological parameters. Parameters investigated included hemoglobin (Hb), mean corpuscular volume, mean corpuscular Hb, mean corpuscular Hb concentration, hematocrit, platelet count, mean platelet volume (MPV), and liver function tests such as alanine transaminase and alkaline phosphatase. Results: Preliminary findings demonstrated significant alterations in hematological parameters post-LC. Changes in MPV, leukocytes, neutrophils, neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, and coagulation factors were observed. Moreover, there was a notable proliferation in thromboembolic measures connected with pneumoperitoneum pressure and surgery duration. Conclusion: LC induces substantial changes in hematological parameters, potentially contributing to postoperative complications. Understanding these alterations is crucial for implementing appropriate pre-, peri-, and post-operative measures to minimize morbidity, mortality, and overall health-care costs. Further investigations are required in interpreting the principal mechanisms and refine strategies for optimizing patient outcomes in LC.

Clinical Value of Mean Platelet Volume to Platelet Ratio (MPR) in Distinguishing Mass-Forming Chronic Pancreatitis and Pancreatic Cancer.

Correctly distinguishing mass-forming chronic pancreatitis (MFCP) from pancreatic cancer (PC) is of clinical significance to determine optimal therapy and improve the prognosis of patients. According to research, inflammation status in PC is different from that in MFCP. Mean platelet volume/platelet ratio (MPR) is a platelet-related inflammation index which has been proven to be valuable in the diagnosis and prognosis of various malignant cancers due to the change in mean platelet volume and platelet count under abnormal inflammatory conditions caused by tumors. Thus, we conducted this study to investigate the clinical value of MPR in distinguishing MFCP from PC. We retrospectively analyzed the data of 422 patients who were suspected to have PC during imaging examination at our department from January 2012 to December 2021. Included patients were divided into the PC (n = 383) and MFCP groups (n = 39), according to their pathological diagnosis. Clinical data including MPR were compared within these two groups and the diagnostic value was explored using logistic regression. The ROC curve between MPR and PC occurrence was drawn and an optimal cut-off value was obtained. Propensity score matching was applied to match MFCP patients with PC patients according to their age and carbohydrate antigen 19-9 (CA19-9). Differences in MPR between groups were compared to verify our findings. The area under the ROC curve between MPR and PC occurrence was 0.728 (95%CI: 0.652-0.805) and the optimal cut-off value was 0.045 with a 69.2% sensitivity and 68.0% accuracy. For all the included patients, MPRs in the MFCP and PC groups were 0.04 (0.04, 0.06) and 0.06 (0.04, 0.07), respectively (p = 0.005). In patients with matching propensity scores, MPRs in the MFCP and PC groups were 0.04 (0.03, 0.06) and 0.06 (0.05, 0.08), respectively (p = 0.005). Multiple logistic regression in all included patients and matched patients confirmed MPR and CA19-9 as independent risk markers in distinguishing PC. Combining CA19-9 with MPR can increase the sensitivity and accuracy in diagnosing PC to 93.2% and 89.5%, respectively. MPR in PC patients is significantly higher than that in MFCP patients and may be adopted as a potential indicator to distinguish MFCP and PC. Its differential diagnosis capacity can be improved if combined with CA19-9.

Evaluation of Mean Platelet Volume in Children with Hypertension.

Childhood hypertension, a disease with increasing prevalence, can lead to severe health problems. With the increased pressure on the vascular endothelium in hypertension, lesions in the endothelium result in endothelial activation and a process of inflammation, which causes platelet activation and in the bone marrow the release of platelet precursor cells into the peripheral blood stream. During inflammation, changes in the number and size of platelets are observed. With the release of platelet precursors into the peripheral blood stream due to platelet activation, an increase in mean platelet volume (MPV) is also seen. Our aim in this study is the evaluation of MPV changes in the hemogram of children suffering from hypertension, a condition causing severe cardiovascular problems. Material and Methods. This research is a descriptive retrospective cross-sectional study. It consists of a patient group diagnosed with hypertension and a control group of children presenting for routine check-ups with no diagnosed hypertension. Demographic characteristics, arterial pressure values, and hemogram parameters have been evaluated. A total of 90 cases were enrolled in the study, including a patient group of 45 cases with hypertension (19 females, 26 males) and a control group of 45 cases (27 females, 18 males). The median age was 15 years in the hypertension group and 13 years in the control group. In the hypertension cases, the thickness of the carotis intima media was statistically significantly greater than in the control group (p < 0.001). Echocardiographic findings (IVSd, LVDd, LVPWd, IVSs, LVDs, LVPWs, and LV mass) were significantly higher in the hypertension group compared to the control group (p < 0.001). A statistically significant difference in platelet count and MPV values between the groups was not found (p = 0.151, p = 0.405, respectively). While MPV is hypothesized to be higher in hypertensive individuals, there was no statistically significant difference between the hypertensive and non-hypertensive groups in this study.

Is dynamic change in mean platelet volume related with composite endpoint development after transcatheter aortic valve replacement?

Aortic valve stenosis (AS) is the most common valvular disease, and surgical or transcatheter aortic valve replacement (TAVR) are the treatment options. Diminish in platelet production or dysfunction may occur due to shear stress, advanced age, and other coexisting diseases in AS patients. Bleeding is one of the complications of TAVR and associated with increased mortality. MPV (mean platelet volume) indicates platelet's thrombogenic activity. Overproduction or consumption of platelets in various cardiac conditions may affect MPV values. We aimed to investigate the pre and postprocedure MPV percentage change (MPV-PC) and its association with post-TAVR short-term complications. A total of 204 patients who underwent TAVR with a diagnosis of severe symptomatic AS were included. The mean age was 78.66 ± 6.45 years, and 49.5% of patients were women. Two groups generated according to composite end point (CEP) development: CEP(+) and CEP(-).110 patients(53.9%) formed CEP(+) group. Although baseline MPV and platelet levels were similar between groups, MPV was increased ( P < 0.001) and platelet was decreased ( P < 0.001) significantly following the procedure when compared to baseline. MPV-PC was significantly higher in the VARC type 2-4 bleeding ( P = 0.036) and major vascular, access-related, or cardiac structural complication groups ( P = 0.048) when CEP subgroups were analyzed individually. Regression analysis revealed that diabetes mellitus [ P = 0.044, β: 1.806 odds ratio (95% confidence interval): 1.016-3.21] and MPV-PC [ P = 0.007,β: 1.044 odds ratio (95% confidence interval): 1.012-1.077] as independent predictors of CEP development at 1 month after TAVR. The MPV increase following TAVR may be an indicator of adverse outcomes following TAVR procedure within 1-month.

Biochemical characteristics and functional performance of cold-stored platelets: an in-vitro comparative study

Background: Platelet refrigeration could eliminate bacterial contamination and improve the hemostatic function even better than already-used room-temperature storage. This study aimed to assess the effect of cold storage, with and without agitation, on the apheresis platelets' hemostatic, metabolic, and functional activity. Materials and methods: The study included 10 healthy volunteer donors to collect Apheresis PLT. They were submitted to careful clinical examination and standard laboratory workup. Collected samples were processed in accordance with American Association of Blood Banks (AABB) guidelines. Every aliquot collected from each volunteer was stored for up to 5 days at one of the following storage conditions: 1. In an FDA-approved-PLT incubator with agitation at room temperature (RT + AG as a group; GI), 2. In an FDA-approved-refrigerator at 4 oC with agitation (4 oC + AG as a group; GII), 3. In an FDA-approved- refrigerator at 4 oC without agitation (4 oC – AG as a group; GIII). The following PLT workup was done; PLT count and mean platelet volume (MPV), metabolic variables, PLT aggregation studies, PLT receptors expression, and PLT pro-inflammatory mediator’s release.Results:All samples had a significant PLT count decline compared to baseline data. No changes in MPV were observed in all groups on day 3 and day 5, meaning that single PLT size remained unchanged. In addition, GI showed a mark of significant increase in metabolic activity when compared to baseline PLTs in contrast to GII, and GIII, which were more metabolically stable and less active.Comparison between the studied groups regarding PLT aggregation revealed significantly higher PLT aggregation response to ADP and collagen in GII and GIII compared to GI on the 3rd and 5th days. Moreover, it was shown that GII and GIII samples had significantly higher CD62p expression when compared with GI on the 3rd and 5th days despite being less active and more stable. While it was found that TXB2 levels were significantly higher, nearly 3-fold, in GI as compared to GII and GIII.Conclusions: Apheresis platelets (AP) cold storage provides a clear advantage over standard conditions regarding biochemical balance and hemostatic performance, which could markedly improve AP's clinical and economic value in different scenarios. Keywords: Platelet aggregation, P-selectin, Thromboxane B2.

The role of mean platelet volume (MPV) and platelet distribution width (PDW) pre-operating as sepsis indicators in laparotomy patients in Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia

Background: Sepsis has become the most common postoperative complication caused by major surgery. Early diagnosis of sepsis is very important to know the patient's prognosis and survival. Changes in mean platelet volume (MPV) and platelet distribution width (PDW) were assessed to have a relationship with the incidence of sepsis. The use of MPV and PDW platelet preoperative indicators is expected to help predict sepsis so that appropriate interventions can be given immediately. Methods: A total of 50 patients who met the inclusion criteria became the subjects of this study to determine the potential of MPV and PDW preoperative biomarkers for predicting sepsis in laparotomy patients. All blood tests for the diagnosis of sepsis were examined. Spearman's test and ROC curve were performed for statistical calculations to determine the cut-off point for MPV and PDW. Results: Analysis of the relationship between PDW and MPV values ​​as an indicator of sepsis using the Spearman test found a significant relationship between MPV and PDW ​​on the incidence of sepsis (p&lt;0.05). Furthermore, statistical tests using the ROC area under the curve (AUC) curve, MPV levels were 0.968, which indicates that if MPV were examined in 100 patients, it would predict sepsis in 96 patients. Meanwhile, the AUC of PDW is 0.770, which shows that if MPV examination is performed in 100 patients, it will predict sepsis in 77 patients. . The best cut-off point ​​that the researchers got in this study was MPV levels 9.8 fL (sensitivity 93.3% and specificity 85%) and PDW levels 9.45 fL (70% sensitivity and 70% specificity). Conclusion: Preoperative MPV and PDW can be predictive indicators of sepsis in laparotomy surgery, with MPV sensitivity and specificity of 93.3% and 85% and sensitivity and specificity of PDW of 70% and 70%, respectively.

COVID-19’da Hemoglobin, Ortalama Trombosit Hacimleri ve Nötrofil Lenfosit Oranındaki Değişiklikler

Objective: It is aimed to evaluate the changes in blood and inflammatory markers (Mean Platelet Volume and Neutrophil Lymphocyte Ratio) in COVID-19. Method: We studied a total of 213 patients. 142 of them consist of patients who have undergone PCR test due to COVID-19 complaints and have a definite diagnosis. The blood values of 71 healthy people of similar age and characteristics without any complaints or symptoms were retrospectively compared. Results: The mean age of the COVID-19(+) group was 54.62±17.71 years, while the COVID-19(-) group was 50.54±15.74 years. 52.8% (n:75) of the patient group and 54.9% (n:39) of the COVID-19(-) group were women. There was a decrease in the number of platelets especially in the PCR(+) group, but statistically no significant difference was observed between the PCR(+) group and the COVID-19(-) group for hemoglobin and platelet values (p&amp;gt;0.05). However, a significant difference (p &amp;lt;0.01) was found in Mean Platelet Volume, neutrophil, lymphocyte and Neutrophil Lymphocyte Ratio. Conclusion: Due to the cytokine storm that develops in COVID-19 infection, a number of changes occur in the blood, especially a decrease in thrombocyte counts. We think that especially the changes in Mean Platelet Volume and Neutrophil Lymphocyte Ratio, which are new inflammatory markers, can be used in the follow-up of this disease and its prognosis.

Role of Routine Blood Parameters in Predicting Mortality Among Surgical Patients With Sepsis.

Outcome prediction for surgical patients with sepsis may be conducive to early aggressive interventions. In several studies, changes in the level of numerous biomarkers like red cell distribution width (RDW), platelet count (PC), mean platelet volume (MPV), and platelet distribution width (PDW)have been demonstrated to be associated with mortality in critically ill patients. We aimed at investigating the prognostic significance of dynamic changes in RDW, PC, MPV, and PDW in surgical patients with sepsis. We prospectively enrolled 110 surgical patients of sepsis in our study admitted to the surgical ward and ICU. We measured RDW, PC, MPV, and PDW on days 1, day 4, and day 8. Receiver operating characteristics (ROC) were generated for prognostic validation of these parameters and mortality in surgical patients with sepsis. Results: We found that higher RDW and PDW on day 1 amongnon-survivors as compared to survivors on day 1 were significantly associated with mortality. ROC curves showed that RDW and PDW on day 1 could be used to predict mortality in surgical patients with sepsis and it was dynamic changes in PC on day 4 and day 8 along with a change in MPV on day 8, which was significantly associated with mortality. The major findings of our study were baseline value of RDW and PDW on day 1 and continuous decrease in PC and increase in MPV over one week weresignificantly associated with mortality. So, it is better to monitor dynamic changes in PC and MPV in combination with baseline RDW and PDW. So, these parameters can bepromising markers to assess prognosis in surgical patients with sepsis.

The Role of Mean Platelet Volume in Multisystem Inflammatory Syndrome in Children With Cardiac Manifestations.

Multisystem inflammatory syndrome in children (MIS-C) is a novel pediatric disorder associated with coronavirus disease 2019. However, no laboratory parameters can diagnose MIS-C. This study aimed to determine the changes in mean platelet volume (MPV) and investigate its relationship with cardiac involvement in MIS-C. In this single-center retrospective study, 35 children with MIS-C, 35 healthy children and 35 febrile children were enrolled. Patients with MIS-C were further subdivided depending on the presence of cardiac involvement. For all patients, the white blood cell, absolute neutrophil, absolute lymphocyte, platelet counts, MPV and C-reactive protein levels were recorded. Ferritin, D-dimer, troponin and CK-MB levels and the day when IVIG was administered were recorded and compared between groups. Thirteen patients with MIS-C had cardiac involvement. The mean MPV of the MIS-C group was significantly higher than those of the healthy ( P = 0.0001) and febrile ( P = 0.027) groups. Using a cutoff of >7.6 fL, the MPV had a sensitivity of 82.86% and specificity of 82.75%, and the area under the MPV receiver operating characteristics curve was 0.896 (0.799-0.956). The MPV was significantly higher in patients with cardiac involvement than in those without ( P = 0.031). Logistic regression analysis revealed that the association between the MPV and cardiac involvement was significant (odds ratio, 2.28; 95% confidence interval, 1.04-2.95; P = 0 .039). The MPV may indicate cardiac involvement in patients with MIS-C. Large cohort studies are needed to define an accurate cutoff value for the MPV.

Validation of Plateletworks ADP for the ProCyte Dx analyzer.

Platelet function testing in cats allows determination of clopidogrel effect. Plateletworks assesses aggregation based on decreasing platelet counts on hematology analyzers in response to agonists. It has not been validated for the IDEXX ProCyte Dx analyzer. Ideal time to perform analysis and the utility of other platelet parameters have not been fully assessed. To validate Plateletworks ADP on the ProCyte Dx, to investigate the utility of various platelet parameters using Plateletworks ADP, and determine the ideal time to perform analysis. Twenty healthy cats recruited from the general population used for transference of reference intervals to a new analyzer, and 10 cats receiving clopidogrel to determine clopidogrel effect. Plateletworks ADP using the ProCyte Dx and ADVIA 2120i analyzer was run simultaneously in both healthy cats and cats receiving clopidogrel, and CBC results at different timepoints were compared between analyzers. Aggregation was significantly different (P< .001) between analyzers. Cohen's kappa showed almost perfect agreement for determination of clopidogrel effect, and the area under the curve of the receiver operating characteristic was 1.0. Lower limits of the aggregation reference interval in healthy cats were 28.8% on the ProCyte Dx and 12.5% on the ADVIA 2120i. Coefficients of variation for platelet parameters were not different between analyzers. No significant changes in mean platelet volume, plateletcrit, large platelets, and mean platelet component were identified. No significant change in aggregation was observed within the first hour after phlebotomy. Our study validated the Plateletworks ADP system on the ProCyte Dx analyzer. Samples may be analyzed up to 1h after collection.

Mean platelet volume, thrombocytosis, and survival in non-small cell lung cancer patients treated with first-line pembrolizumab alone or with chemotherapy.

Patients treated with immune checkpoint inhibitors (ICIs) may not response to treatment and are at risk for immune-related adverse events (irAEs). Platelet function has been linked to both oncogenesis and immune evasion. We studied the association between the change in mean platelet volume (MPV), platelet count, survival, and the risk of developing irAEs in patients with metastatic non-small cell lung cancer (NSCLC) who have received first-line ICI. In this retrospective study, delta (∆) MPV was defined as the difference between cycle 2 and baseline MPV. Patient data were collected via chart review, and Cox proportional hazard and Kaplan-Meier method were used to assess the risk and estimate median overall survival. We identified 188 patients treated with first-line pembrolizumab, with or without concurrent chemotherapy. There were80 (42.6%) patients received pembrolizumab monotherapy, and 108 (57.4%) received pembrolizumab in combination with platinum-based chemotherapy. Patients whose MPV (∆MPV ≤ 0) decreased had hazard ratio (HR) = 0.64 (95% CI 0.43-0.94) for death with p = 0.023. Patients with ∆MPV ≤ -0.2 fL (median), there was a 58% increase in the risk of developing irAE (HR = 1.58, 95% CI 1.04-2.40, p = 0.031). Thrombocytosis at baseline and cycle 2 was associated with shorter OS with p = 0.014 and 0.039, respectively. Change in MPV after 1 cycle of pembrolizumab-based treatment was significantly associated with overall survival as well as the occurrence of irAEs in patients with metastatic NSCLC in the first-line setting. In addition, thrombocytosis was associated with poor survival.

The effects of mean platelet volume and red cell distribution width on prognosis in patients with myelodysplastic syndrome

Objective: In this study, the relationship between changes in mean platelet volume (MPV) and erythrocyte distribution width (RDW)&#x0D; with hematological response and survival in patients with myelodysplastic syndrome was investigated.&#x0D; Patients and Methods: Between 1 January 2011 and 31 December 2018, patient characteristics and hemogram results were evaluated&#x0D; during the treatment process among 158 patients diagnosed with myelodysplastic syndrome.&#x0D; Results: The mean age of the patients who were included in the study was 71.53±12.6 years. The MPV percentage change in the 2-year&#x0D; follow-up of the patients with and without hematological response was significant, at 0.022±0.11 (2.2%) in those who responded and&#x0D; at 0.069±0.15 (6.9%) in those who did not (p=0.049). Throughout the same period, the degree of RDW changes in the patients who&#x0D; died was 13.23±22.97, the degree in those who survived was 2.86±21.42, and the difference between the two groups was statistically&#x0D; significant (p=0.006).&#x0D; Conclusion: In patients diagnosed with myelodysplastic syndrome, MPV and RDW values can be considered inexpensive and simple&#x0D; laboratory markers that can be used in follow-ups and promising tests to predict both treatment response and survival in the early&#x0D; period and change treatment modalities.

The impact of SGLT2-inhibitor therapy on platelet function in type 2 Diabetes mellitus

Aim: We consider mean platelet volume (MPV), a pointer of platelet activity related to type 2 diabetes mellitus (T2DM) and vascular complications, may have a role in patients using Sodium-Glucose Co-Transporter 2 inhibitors (SGLT2i). Therefore, we aimed to evaluate the MPV change after SGLT2i use in diabetic patients.Matherial and Method: Hemogram parameters such as hemoglobin, hematocrit, and MPV in the 0th and 24th weeks of 102 patients with T2DM that received SGLT2i treatment added to their existing medications and of the control group in which participants are compatible in terms of age and gender factor were compared.Results: A significant increase was observed in the values of MPV and hemoglobin in the 0th and 24th weeks (9.3 (8.2-10.3) to 10.1±1.3, p&amp;lt;0.001, 13.9±1.42 to 14.4±1.5 p&amp;lt;0.001, respectively). Similarly, the hematocrit value increased (42±3.7 to 44.2±3.8, p&amp;lt;0.001). There was also a significant increase in both red blood cell (RBC) and platelet counts (5±0.42 to 5.2±0.47, p&amp;lt;0.001, 252,000 (209,000-304,000) to 262,000 (221,000-322,000), p=0.007, respectively). No correlation was identified in patients with T2DM between MPV and age and gender factors, diabetes duration, body mass index (BMI), fasting and postprandial blood glucose, and insulin use.Conclusion: Contrary to the studies analyzing the relation between MPV and T2DM and its complications, we detected that a 24-week SGLT2i treatment led to an increase in MPV value.

Platelet indices as a predictor of microvascular complications of type 2 diabetes mellitus

Background: The burden of diabetes is increasing day by day, and diabetic individuals are predisposed to develop micro- and macrovascular complications leading to increased mortality and morbidity. Platelet indexes can alert us regarding endothelial dysfunction in diabetes and in turn regarding microvascular complications. Materials and Methods: A case–control study was conducted on 100 diabetic patients with age and sex matched and 100 nondiabetic controls. All diabetic patients were evaluated for microvascular complications such as diabetic neuropathy, retinopathy, and nephropathy. Clinical history of all patients was taken regarding associated comorbidities and association. Fasting and postprandial blood sugar, HbA1c, platelet count, and platelet indices were measured. Statistical analysis was performed by using student unpaired t test and χ2 test. Results: Platelet indices mean platelet volume, plateletcrit, platelet distribution width (PDW), and platelet large cell ratio (P-LCR) were significantly higher in diabetic patients compared with controls. It was also observed that changes in mean platelet volume, PDW, and P-LCR were more significant in diabetic patients with microvascular complications than diabetic patients without microvascular complications. Conclusion: Values of platelet indices were statistically associated with diabetes and its microvascular complications.

In vitro Investigation of Platelet Dysfunction Induced by Osmotic Pressure Variations

Background: Severe variations in osmotic pressure are significant contributors to critical patient morbidity and mortality and might also affect platelet volume. We aimed to investigate possible osmotic-induced changes in mean platelet volume (MPV) and their possible effects on platelet aggregation activity (PLAG). Methods: We induced experimental variations of serum osmolality in blood samples from healthy volunteers (heparinized whole blood [WB]) and isolated platelets (platelet-rich plasma [PRP]) by adding isotonic, hypertonic, and hypotonic solutions of saline/water (pH = 7.2–7.4). PLAG was tested in WB samples with impedance aggregometry (IA) and in PRP samples with light transmission aggregometry (LTA) using three agonists: adenosine diphosphate (ADP, 10 μ<sc>m</sc>), thrombin receptor activating peptide (TRAP-6, 10 μ<sc>m</sc>), and arachidonic acid (500 μ<sc>m</sc>). Osmolality was either calculated using a formula or measured directly. Results: We found almost identical osmolalities in WB and PRP preparations. Osmotic stress did not produce significant changes in MPV. In IA testing, the hypotonic challenge of WB preparations produced significant reductions at 50% (p = 0.056) (95% CI: 11.2–2.4, in Ohms) of ADP and at 31% (p = 0.017) (95% CI: 13.4–8.6, in Ohms) of TRAP-6-induced PLAG, respectively. In PRP, we did not observe any variations in PLAG with LTA. Conclusions: We conclude that in vitro hypotonic stress of WB samples has an inhibitory effect on the PAR-1 (TRAP-6-induced) pathway and on the P2Y₁₂ (ADP-induced) pathway and reflects a distinct in vivo effect of hypoosmotic stress on WB human platelet preparations.

Variability of mean platelet volume in patients with ischemic stroke in the early recovery period depending on comorbidity

High platelet reactivity in patients with ischemic noncardioembolic stroke is associated with an increased risk of recurrent ischemic events. However, their determinants are still poorly understood. The aim of our study was to examine changes in mean platelet volume in patients with ischemic stroke in the early recovery period depending on comorbidity.Material and methods. Clinical and laboratory analysis of 90 patients with acute noncardioembolic stroke of the early recovery period. Among those surveyed were 49 men and 41 women aged (60.42 ± 6.8) years. Platelet count (PLT) and mean platelet volume (MPV) were determined on an Abacus 30 hematology analyzer.Results. Significantly more often, the highest mean platelet counts were observed in patients with atherothrombotic subtype of ischemic stroke with greater neurological deficit. Patients with the highest MPV rates had a higher prevalence of diabetes, an elevated body mass index, and a degree of cerebral atherosclerosis compared with patients with lower MPV levels.Conclusion. The increase in MPV in patients with ischemic stroke is observed in parallel with the increase in the influence of known factors in the development of cardiovascular diseases that cause the progression of vascular endothelial damage and atherothrombosis and indicates an increased risk of recurrent stroke.

Does The Mean Platelet Volume Change in Hand-Foot and Mouth Disease?

Amaç: El-ayak-ağız hastalığı (EAAH); ateş, deri ve mukoza lezyonları ile seyreden, çocukluk çağının&#x0D; enteroviral döküntülü bir hastalığıdır. Ortalama trombosit hacmi (MPV) trombosit fonksiyonu ile ilişkilidir&#x0D; ve çeşitli bozukluklarda klinik ilginin bir göstergesi olarak trombosit sayısından daha hassas bir&#x0D; indeks olabilir. Biz bu çalışmada; EAAH‘da MPV seviyeleri, değişir mi ve onikomedozis gibi sonradan&#x0D; gelişebilecek bulguları önceden saptamada yol gösterici olabilir mi sorularına cevap aramaya çalıştık.&#x0D; Gereç ve Yöntemler: Hastanemiz Çocuk Sağlığı ve Hastalıkları Bölümüne 2018-2019 yılları arasında&#x0D; başvurup klinik olarak EAAH’ı tanısı alan 52 hasta çocuk ve 48 sağlıklı kontrollerin geriye dönük olarak&#x0D; demografik verileri, şikayetleri ve fizik muayene bulguları ve tam kan sayımı parametreleri değerlendirildi.&#x0D; Bulgular: Hastaların ortalama yaşları 3,3 ±2,5 yıl, kontrol grupta ise 3,2 ± 2,6 yıldı. Hastaların %59,6&#x0D; erkek, %40,4’ü kız idi. Gruplar arasında yaş ve cinsiyet olarak bir farklılık saptanmadı. Hastaların en sık&#x0D; Mayıs- Haziran aylarında başvurduğu (%63,6) görüldü. En sık başvuru şikayeti döküntü (%100), oral&#x0D; aft (%80,7) ve ateş (%76,9) idi. Hastaların dördü (%7,6) çeşitli nedenlerle yatırılarak tedavi edildi. Tam&#x0D; kan incelemesi yapılan hastaların ortalama lökosit değeri 10459±3485/mm3 iken bu oran sağlıklı grupta&#x0D; 6900±2175/mm3 (p=0,019) idi. Hasta ve kontrol grubunda sırayla ortalama MPV değeri 7,02±1,49 fL,&#x0D; ve 8,1±1,2 fL (p=0.001) idi. Hasta grubunda tırnak bulguları gelişenlerle gelişmeyenler arasında yaş,&#x0D; cinsiyet tanı ayı ve MPV değerleri arasında bir fark saptanmadı (p=0.36).&#x0D; Sonuç: Özellikle MPV değeri kontrol grubuna göre anlamlı düşük saptanmıştır. Bundan dolayı özellikle&#x0D; döküntüsü henüz ortaya çıkmamış olan ve arada kalınan hastaları erken öngörmede bu değerin de&#x0D; kullanılabileceğini düşünmekteyiz.

Case controlled study on diagnostic predictive value of inflammatory markers of complete blood count in pregnant women with acute appendicitis

The aim of this study is to evaluate and compare the diagnostic ability of platelet-related parameters and white cell-based parameters in pregnant women with appendicitis. This is a retrospective case-controlled study. Women aged between 18 and 50-years-old who had undergone appendectomy between January 2010 and January 2021 were enrolled in the study. Age, pathological diagnosis and relevant laboratory parameters were recorded for each patient. Gestational characteristics were recorded for pregnant patients. There were 58 pregnant and 1171 non-pregnant women enrolled. Pregnant women with acute appendicitis were significantly younger (p < .0001, d= −0.532), had significantly lower PLT (p = .002, d= −0.428) and ALC (p = .033, d= −.304) levels but had significantly higher MPV (p = .004, d = .415) levels than non-pregnant counterparts. In pregnant women, only MPV was the independent predictor of acute appendicitis (OR: 1,952). MPV cut-off value of 9,6 fL provided 63,5% sensitivity, 67,7% specificity, 94,2% PPV and 17,3% NPV whereas 10 fL provided 55,8% sensitivity, 100% specificity, 100% PPV and 21,4% NPV for acute appendicitis in pregnant women. Therefore, MPV might be useful for diagnosing acute appendicitis in pregnant women. Impact statement What is already known on this subject? In pregnant women, counts and percentages of white blood cells and neutrophils are known to be independent predictors of acute appendicitis. Meanwhile, physiologic leukocytosis of gestation is a challenge for interpretation of these parameters. Platelets and related markers are, as well, predictive for inflammatory processes in the human body. What do the results of this study add? The role of platelet-related markers in the diagnosis of acute appendicitis in pregnant women has not been studied previously. The results of the present study indicate that in pregnant women, changes in mean platelet volume might be an independent predictor of acute appendicitis. What are the implications of these findings for clinical practice and/or further research? Further similar large-scale case-controlled or cohort studies are required to validate the present results. In pregnant women with abdominal pain, the use of mean platelet volume as a biomarker could reduce negative laparotomy rates. A mean platelet volume is a useful tool for diagnosing acute appendicitis in pregnant women and provides helpful guidance for clinicians dealing with these patients in the emergency room.

Mean platelet volume (MPV): new diagnostic indices for co-morbidity of tuberculosis and diabetes mellitus

BackgroundTuberculosis (TB) and type 2 diabetes mellitus (DM) are global health diseases with high morbidity and mortality. Few studies have focused on platelet indices in TB-DM coinfection patients. The objective of this work was to analyze the platelet indices in TB, DM and TB-DM patients to assess the predictive value of the platelet index for the risk of these diseases.MethodsIn total, 246 patients admitted to our hospital were distributed into three groups (113 TB, 59 DM and 74 TB + DM). A total of 133 individuals were also recruited as healthy controls (HC). Platelet indices, namely, platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW), were compared among the four groups, and the relationship with inflammatory markers was explored by using statistical software.ResultsOur study discovered that MPV and PCT were significantly downregulated in TB + DM patients (9.95 ± 1.25 fL, 0.20 ± 0.05%, P < 0.0001, P = 0.0121, separately) compared with DM individuals (10.92 ± 1.17 fL, 0.22 ± 0.04%). Moreover, the changes in MPV were significantly higher in TB + DM patients (9.95 ± 1.25 fL, P = 0.0041) than in TB patients (9.42 ± 1.01 fL). No differences were found in PLT and PDW among the four groups (P > 0.05). The sensitivity and specificity of MPV in the differential diagnosis of DM patients vs TB + DM patients were 64.9 and 66.1% (P < 0.0001), respectively, and the sensitivity and specificity of MPV between TB patients and TB + DM patients was 60.8 and 66.4%, respectively (P = 0.003). MPV improved the diagnosis sensitivity when it was combined with clinical parameters, such as fasting blood glucose in DM and Mycobacterium tuberculosis culture result in TB (76.3% vs 64.9, 72.6% vs 60.8%, P < 0.0001, P = 0.001, respectively). In addition, the sensitivity and specificity of PCT in the differential diagnosis of DM patients vs TB + DM patients were 69.5 and 59.4%, respectively (P = 0.008). PCT improved the diagnosis sensitivity when combined with fasting blood glucose in DM (72.9% vs 64.9%, P = 0.004). In addition, MPV was linked to CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) in the TB + DM patients (r = 0.3203, P = 0.0054, r = 0.2504, P = 0.0307) but PCT was not (r = 0.1905, r = 0.008675, P > 0.05, respectively).ConclusionsOur research shows that MPV and PCT might be good clinical laboratory markers to distinguish TB + DM patients from TB or DM individuals, thus providing support for earlier clinical diagnosis, prevention, and therapy.

Increased Mean Platelet Volume is Associated with Decreased Survival in Cardiogenic Shock Patients Receiving Mechanical Circulatory Support

Purpose Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is a significant source of morbidity/mortality despite advances in reperfusion and mechanical circulatory support (MCS) therapies. Both MCS devices and shock have been associated with increased mean platelet volume (MPV), likely due to exposure to foreign surfaces and bone marrow activation, respectively. Larger platelets are more reactive, produce more prothrombotic factors, and are more likely to undergo adhesion/aggregation. Increased MPV is also associated with higher risk of MI and stroke in the general population. An association between MPV and outcomes in patients treated with short-term MCS for CS has not been investigated. Methods This study included 279 patients diagnosed with AMI complicated by CS. MPV and platelet count (PC) were analyzed in patients who required MCS with either intra-aortic balloon pump (IABP) or Impella®. Patients who did not receive MCS served as control. MPV and PC were assessed prior to device placement, 24-hrs, and 7-days post device. Percent change in MPV (∆MPV%) was calculated. 30-day all-cause mortality was recorded. Results There were 29.3% females, 65.5+/-12.1 years-old, 30.3% with HTN, 29.1% CAD, 20.3% DM, 18.8% HLD, and 8.1% A-fib. All patients experienced a rise in MPV. However, the 56 (20.1%) patients who expired within 30-days of admission experienced a greater rise in MPV (∆MPV% at 7d: 4.69+/-1.09% expired vs. 1.69+/-0.53% survivors; p Conclusion This pilot study indicates that increased MPV and decreased PC are associated with increased risk of mortality in CS patients treated with short-term MCS, specifically IABP or Impella®. MPV and PC are simple to measure and widely available lab results. As such, they may be useful in identifying high risk patients and for estimating prognosis. More studies on this subject are necessary.