Mean Platelet Volume Measurement Research Articles

Clinical significance of mean platelet volume, platelet distribution width, and neutrophil-lymphocyte ratio in children with familial mediterranean fever

Objective: Familial Mediterranean Fever (FMF) is an autosomal recessive disease characterized by recurrent fever and polyserositis. Studies conducted in recent years emphasize the importance of platelet parameters in chronic diseases. This study examined changes in attack and attack-free periods in children with FMF, focusing on Mean Platelet Volume (MPV), an indicator of disease severity. Method: 150 FMF patients (90 girls, 60 boys) and 50 healthy individuals (29 men, 21 women) were included in the study. Data were analyzed according to colchicine treatment, attack, and attack-free periods. The severity of the disease was classified as mild, moderate, and severe. Results: MPV levels of patients with FMF were higher than the healthy group. In particular, MPV levels decreased significantly during attacks, with a more pronounced decrease in severe cases. Conclusion: As a result, MPV measurement is a cost-effective and rapid method that can support the evaluation of disease severity and attack periods in FMF patients.

Obstrüktif Uyku Apnede (OUA) Ortalama Trombosit Hacmi (OTH) ve OUA'da Sürekli Pozitif Hava Yolu Basıncı (CPAP) Tedavisinin OTH Üzerine Etkisi

Aims: In this study, our objective was to evaluate mean platelet volume (MPV), an indirect marker of platelet activation, in patients with obstructive sleep apnea (OSA), and assess the effect of OSA treatment with continuous positive airway pressure (CPAP) on MPV
 Methods: In this study, records of consecutive patients who underwent polysomnographic evaluation for OSA symptoms in the Sleep Disorders Laboratory during a one-year period were reviewed retrospectively. Patients who had both complete blood count and MPV measurements were included in the study.
 Results: A total of 158 patients, including 51 females (32.3%) and 107 males (67.7%), were included in the study. The mean age of the patients was 51±13 (min-18, max-82) years. OSA was detected in 74.1% (117/158) of the patients. It was determined that as the severity of OSA increased, hemoglobin and hematocrit values increased significantly. There was no significant difference in platelet count according to the presence and severity of OSA. The MPV was significantly lower in severe OSA cases compared to those without OSA and mild OSA cases. A negative correlation was observed between MPV and the apnea-hypopnea index, desaturation index, and the amount of oxygen saturation below 90% during sleep. There was no significant difference in median erythrocyte and thrombocyte counts, hematocrit percentage and hemoglobin values before and after treatment in OSA patients who used CPAP therapy. However, a significant decrease in MPV was observed after OSA treatment compared to pre-treatment. (p=0.021).
 Conclusions: The results of the study do not support an increase in MPV and hence platelet activation in severe OSA patients compared with those without OSA. However, the results suggest that one month of CPAP treatment reduces MPV and thus platelet activation in severe OSA patients. Further controlled, prospective studies including treatment outcomes are needed on this subject.

Clinical significance of platelet membrane glycoproteins in children with primary immune thrombocytopenia

Abstract Objectives To measure CD62p and CD42b levels and to study its correlations with bleeding score, and different prognostic factors in children with primary immune thrombocytopenia (ITP) patients. Methods In all, 60 children with ITP and 30 age- and sex-matched healthy participants were recruited and underwent thorough clinical assessments including bleeding score using the modified Buchanan and Adix bleeding score as well as complete blood count with measurement of mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT), coagulation profiles and measurement of platelet glycoproteins (CD62p and CD42b) using a flow cytometer. Results Children with ITP had lower PCT (P<0.001), CD 62 P, and co-expression of CD 42b/CD 62 P and higher MPV (P=0.009), PDW (P<0.001), and CD 42b level. MPV correlates negatively with lymphocyte count and platelet count, while PDW correlates negatively with neutrophil count and positively with hemoglobin. PCT correlates negatively with total leucocyte count, neutrophil count, and positively with platelet count (P=<0.001). Children with chronic ITP usually presented with mild cutaneous bleeding, while those with acute ITP usually suffered from severe mucosal and life-threatening bleeding (P=0.001). Acute ITP cases had the highest total leucocyte count (P<0.001) and the lowest count of platelet (P<0.001); persistent cases had the lowest lymphocyte count (P=0.023) and co-expression of CD42b/CD62p (P=0.039), while chronic cases had the lowest neutrophil count P<0.001) and highest percentage of PCT (P<0.001) and co-expression of CD42b/CD62p (P=0.039). Conclusion Platelet parameters and platelet glycoprotein CD62P and CD42b expression is a simple noninvasive diagnostic tool in ITP children.

Mean Platelet Volume in Type 2 Diabetes: Correlation with Poor Glycaemic Control

Background: Diabetes is a global pandemic. Mean platelet volume (MPV) is an indicator of increased platelet activity, which is considered to play a role in the development of vascular complications in diabetes. Platelet volume is strongly and independently related with glycaemic control in Type 2 diabetes (T2D). Aim: To study the MPV in patients with T2D, and its correlation with HbA1c, duration of T2D, and microvascular complications. Methodology: This was a cross-sectional, observational study conducted at the Department of Medicine, Gandhi Medical College, Bhopal, India, during a period of 18 months on 300 patients with T2D. Blood glucose, HbA1c, MPV, fundoscopy, and 24-hour urine protein were done. Data were represented as mean+/-standard deviation and statistical analysis was done using SPSS software (IBM, Armonk, New York, USA). Results: The mean age of patients was 56.64±8.69 years, with 52% of the patients being females. Of these patients, 18.3% had HbA1c between 6.5–8.0%, 51.7% between 8.1–10.0% and the rest above 10.0%. A total of 51% of the patients had diabetes for 6–10 years of duration and 30% for more than 10 years. Patients with higher HbA1c level and prolonged duration of diabetes had higher MPV (p<0.001). Patients with advanced diabetic retinopathy changes and nephropathy also had higher MPV (p<0.05). Conclusion: Measurement of MPV in patients with T2D can be a useful and easily available prognostic marker, and hence assist clinicians to anticipate the occurrence of microvascular complications associated with the disease, especially in resource-poor settings, and reduce the burden of cost for the patient.

Relationship of platelet subgroups with prognosis and mortality in patients with mild, severe and critical COVID-19

Introduction: This study investigates whether platelet-related indicators including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), Plateletcrit (PCT), and platelet large cell ratio (P-LCR) could be effective biomarkers in the prognostic of 2019-novel coronavirus disease (COVID-19) fatality. 
 Methods: Out of 380 patients diagnosed with COVID-19, 98 patients were randomly and retrospectively were included in our study. Detection of COVID-19 was performed according to the World Health Organization (WHO) guidelines and using quantitative polymer chain reaction (qPCR). Clinical and laboratory data and medical records for all study participants were collected from a digital version of their health history at Ayancik State Hospital and Diyarbakır Gazi Yaşargil Training and Research Hospital. All patients were followed up daily until discharge or death and were eventually classified into three categories: Mild, severe, and critical patients. Data analysis was performed using SPSS-26 for Windows (Statistical Package for Social Science, SPSS Inc. Chicago IL, USA®Z), and a 95% confidence level was selected. P < 0.5 was considered statistically significant.
 Results: Of participants, 64.3% of the patients are 65 years and older, 54.1% are male, 60.2% survived, 39.8 % died and 35.7% are in critical condition. The mortality rate is higher in males and 65 years and older. While PLT (190,24) and PCT (0,21) measurements were higher in surviving patients, MPV (10,67), PDW (16,15) and P-LCR (30,82) measurements were higher in deceased patients. PDW and PCT measurements are more effective in predicting mortality state according to Roc analysis. The measurement that best predicts the deceased status of patients who are positive according to the cut-off value determined is PDW (0.621), and the measurement that best estimates the surviving patients is PLT (0.925).
 Conclusions: In our study, it was concluded that high MPV, PDW and P-LCR and low platelet values are associated with poor prognosis of COVID-19 disease, and PDW and PCT measurements are more effective in predicting mortality in patients with COVID-19 infection. Laboratory parameters such as MPV, PDW, P-LCR, PDW, and PCT can provide clinicians with predictions of prognosis and mortality from COVID-19 disease.

Mean platelet volume: a prognostic marker in heart failure with preserved ejection fraction

Heart failure (HF) with preserved ejection fraction (HFpEF) is associated with high burden of comorbidities known to increase the mean platelet volume (MPV). This parameter has been associated with morbidity and mortality in HF. However, the role of platelets and the prognostic relevance of MPV in HFpEF remain largely unexplored. We aimed to evaluate the clinical usefulness of MPV as a prognostic marker in HFpEF. We prospectively enrolled 228 patients with HFpEF (79 ± 9 years; 66% females) and 38 controls of similar age and gender (78 ± 5 years; 63% females). All subjects underwent two-dimensional echocardiography and MPV measurements. Patients were followed-up for a primary end point of all-cause mortality or first HF hospitalization. The prognostic impact of MPV was determined using Cox proportional hazard models. Mean MPV was significantly higher in HFpEF patients compared with controls (MPV: 10.7 ± 1.1fL vs. 10.1 ± 1.1fL, p = .005). HFpEF patients (n = 56) with MPV >75th percentile (11.3 fL) displayed more commonly a history of ischemic cardiomyopathy. Over a median follow-up of 26 months, 136 HFpEF patients reached the composite endpoint. MPV >75th percentile was a significant predictor of the primary endpoint (HR: 1.70 [1.08; 2.67], p = .023) adjusted for NYHA class, chronic obstructive pulmonary disease, loop diuretics, renal function, and hemoglobin. We demonstrated that MPV was significantly higher in HFpEF patients compared with controls of similar age and gender. Elevated MPV was a strong and independent predictor of poor outcome in HFpEF patients and may be relevant for clinical use.

Mean Platelet Volume a Risk Indicator in Acute Coronary Syndrome

INTRODUCTION: Coronary artery disease is the disease manifested mainly the process of atherosclerosis and their complications. Platelets have a major part in the atherosclerosis process initiation and the formation of thrombus in the coronary vessels. Larger the size of the platelet , higher the risk of thrombosis as it is metabolically and in enzymatic way more active compared to smaller platelets.1 Since MPV gives the measurement of average size of the platelets, MPV measurement predicts the risk of developing Acute coronary syndrome. METHOD: All patients who come to Emergency Department and Out patient Department of Sree Balaji Medical College and Hospital with chest pain who are not a known case of Acute Coronary Syndrome, and fulfilling the inclusion and exclusion criteria will be taken for our study. As soon as patient got admitted , informed consent was obtained from patients and attenders. Initial evaluation involves thorough clinical history and examination, Electrocardiography and Troponin I (biomarker). Venous samples for troponin I and MPV will be taken at the time of arrival and before the treatment initiation and the platelet volume indices are assessed and the correlation between ACS (STEMI, NSTEMI) and Non ACS patients with MPV values are assessed and also among STEMI and NSTEMI patients. RESULTS: Mean platelet volume (MPV) was assessed in our study and we have found it higher in ACS patients (9.716 ± 0.829) compared to the control group (8.730 ± 0.840) , which was significant , P wave of less than 0.05. It was also determined that high MPV values were there among patients who are diagnosed with STEMI as compared with NSTEMI with values of 9.98 ±0.675 and 9.412 ±0.896 , significant statistically (P less than 0.05). CONCLUSION: In our study, MPV values assessed were obtained to be high in ACS diagnosed patients than with Control group and similarly MPV values were high in the patients with STEMI patients more than in NSTEMI and also proved it to be significant . Hence it could be useful as a simple test with other biomarkers in the prediction of ACS earlier. Large platelets are usually metabolically active more , they carry the higher risk of developing coronary thrombosis leading to the Acute coronary syndrome. As this test could be done in routine analysis and could help in ACS early detection.

ASSOCIATION AND CORRELATION OF MEAN PLATELET VOLUME AND PLATELET COUNT IN ACUTE ISCHEMIC STROKE

Objective: Role of platelets in the pathogenesis of the atherothrombosis and ischemic stroke has been documented. Mean platelet volume (MPV) and platelet count (PC) could be important predictors of acute ischemic stroke (AIS), its severity; therefore we investigated the correlation of MPV & PC in AIS patients. Methods: We studied MPV and PC of 52 AIS patients consecutively admitted in Neurology department at Geetanjali Medical University, India. Platelet variables were measured and compared with control of similar age, sex and without vascular events. Results: Out of 52 patients, 30 (57.69%) had Thirty (57.69%) patients had significantly higher MPV in AIS group (12.45fL compared with normal range of 6–11 fL in control,p<0.001). No significant differences were found between male and females, but the total mean was elevated. The mean of PC was 1.76×105 cells/cumm (normal range) and there was no correlation between the change in PC and AIS in both sexes. Repeated measurements of MPV and PC were also recorded on follow-up which showed no significant changes from the acute phase; however, MPV remained elevated. The comparison of MPV in patients with mRS score 2 versus 4, 2 versus 5, 3 versus 4 and 5, and 4 versus 5 were found to be statistically significant (p<0.05). Conclusion: Increased MPV has an independent association with AIS and its severity and it could not change after acute treatment. It is possible that these changes precede the vascular event, and further studies are warranted to unravel the underlying mechanism.

The Correlation of Mean Platelet Volume and Neutrophil-lymphocyte Ratio Measurements, and the Ishak Fibrosis Score in Our Patients with Chronic Hepatitis B

Background:The ishak score determined by liver biopsy is the most reliable indicator of fibrosis, but biopsy is an invasive procedure. Numerous noninvasive tests have been investigated to determine the hepatic fibrosis score. We aimed to investigate the relationship between the mean platelet volume(MPV) and neutrophillymphocyte ratio (NLR) measurements in patients with chronic hepatitis B virus (CHB) infection, and liver fibrosis stage, which was determined by biopsy and ishak score. Material and Method:CHB patients followed between 2016 and 2020 in our gastroenterology outpatient clinic were included in our study. CHB patients; They were divided into two groups as non-cirrhotic group (ishak fibrosis score in biopsy; F0-F4) and cirrhotic group (F5-F6). Then, 30 healthy control (HC) groups consisting of health personnel who had routine health screenings and blood tests in the same period were formed. MPV, NLR measurements of these two main groups and CHB subgroups and liver biopsy results of CHB patients were evaluated retrospectively, and possible relationships between the groups were investigated. Results:There was no statistically significant difference between the mean age and gender of the cases in the CHB and HC groups. A total of 54 patients with CHB were identified, of which 13 patients were cirrhotic and 41 patients were non-cirrhotic. MPV measurements were found to be significantly higher in the CHB group than in the SC group (11.15±1.77; 10.02±0.92; p=0.002). While there was no significant difference between NLR measurements, it was found to be higher in the CHB group (1.98±0.81; 1.81±0.69). While there was no significant difference between the cirrhotic and non-cirrhotic subgroups of the CHB group in terms of NLR (1.86±0.68; 2.36±1.04) and MPV (11.09±1.89; 11.35±1.36) measurements, NLR and MPV measurements were higher in the cirrhotic group. Conclusion:In our study, MPV values were found to be significantly increased in patients in the CHB group compared to the HC group. In addition, although not statistically significant, NLR and MPV measurements were found to be higher in the cirrhotic group than in the non-cirrhotic group. According to our study, it can be thought that with increasing MPV and NLR measurements in HBV patients, there may be an increase in chronicity and fibrosis scores without an invasive procedure such as biopsy.

The pattern of systemic inflammation index in normotensive non-dipper and dipper hypertensive patients

Objective: Continuous inflammation at the level of the vascular endothelium plays an important role in the formation of hypertension. Diurnal blood pressure (BP) variation also is a risk factor for hypertensive target organ damage. This study planned to evaluate these inflammation processes in normotensive and hypertensive patients. Methods: This study is observational cross-sectional cohort in-design. 151 patients with a prediagnosis of hypertension included. The patients were divided into three groups (group 1: dipper normotensive, group 2: non-dipper normotensive, group 3: dipper-hypertensive) based on the results of ambulatory blood pressure monitoring. The groups were compared in terms of systemic inflammation index (SII; platelet count×neutrophil count/lymphocyte count), neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and other inflammation processes. Results: There was a significant difference between the three groups in terms of mean platelet volume (MPV) and red blood cell distribution width (RDW) levels (p=0.001 and p<0.001, respectively). A statistically significant difference was found between the groups in terms of NLR, PLR, systemic inflammation index, lymphocyte-monocyte ratio (LMR). In subgroup analysis, NLR and systemic inflammation index were similar in group 2 and group 3, but higher than in group 1 in both groups. LMR was similar in group 2 and group 3 but lower than in group 1. In subgroup analysis PLR levels were similar in group 2 and group 3 but higher than group 1 in both groups. Conclusion: This study showed that normotensive non-dipper patients had inflammation as much as dipper hypertensive patients according to measurement of MPV, RDW systemic inflammation index, PLR, NLR levels.

Platelet counts and adenoid hypertrophy: a neglected relationship.

The increase in resistance of the respiratory nasal caused by adenoid hypertrophy can condition changes in pulmonary ventilation and translate into a risk of cardiopulmonary diseases. The mean platelet volume is a marker of platelet function, associated with indicators of platelet activity - a greater volume indicates the presence of larger platelets and greater hemostatic reactivity, associated with a propensity for thrombosis. Retrospective study of 200 patients who presented to the otolaryngology outpatient clinic of our hospital, divided in two group-s : chAil dren with adenoid hypertrophy, B - children without adenoid hypertrophy. The age, hemoglobin levels, platelet counts were compared between the two groups. The Mean Platelet Volume levels in patients with Adenoid Hypertrophy were significantly higher than those in the control group (p<0.001). White blood cells, hemoglobin, and platelet levels were not significantly different between the 2 groups (P > 0.05). Adenoid hypertrophy is associated with higher mean platelet volume in children. Measurement of mean platelet volume and platelet count can be considered as quick, safe, and reliable guide for the assessment of clinical consequences of adenoid hypertrophy.

Relationship between mean platelet volume and intensive care unit requirement in COVID-19 patients

Objective: Our aim in this study is to examine the relationship between the mean platelet volume (MPV) and the intensive care unit (ICU) requirement in patients with 2019 coronavirus disease (COVID-19).&#x0D; Methods: This retrospective observational study was conducted with patients who were diagnosed with COVID-19 in the emergency department of a tertiary hospital. The study was continued with the remaining 711 patients after using the inclusion and exclusion criteria. CHAID analysis was used as the decision tree method in analyzing the data. The relationship between ICU requirement and MPV were evaluated.&#x0D; Results: There were 711 patients included in this study. The median age of the population was 64 (49-76). According to the CHAID analysis, the study population was divided into 2 classes as those who aged 58 years or younger (Younger Group) and those who older than 58 years (Older Group), and the relationship between the 8.3 threshold value of MPV and the ICU requirement was analyzed. For the Younger group, a significant difference was found in terms of ICU requirement based on the 8.3 threshold value of MPV.&#x0D; Conclusion: Advanced age, high MPV and PLT values in COVID-19 patients, are associated with the ICU requirement. The 8.3 threshold value of MPV can be used as one of the parameters determining the ICU requirement in relatively young patients. In the geriatric age group, it is not beneficial to use MPV measurement to assign the ICU requirement. Multi-center studies with a large number of patients are needed to present the strength of the results of our study more clearly.

Is there an association between mean platelet volume and diabetic retinopathy? A case-control study.

Background:To the aim of this study was to evaluate the association between mean platelet volume (MPV) and diabetic retinopathy (DR).Methods:Patients with diabetes mellitus (DM) referred to Ophthalmology Clinic of Rohani Teaching Hospital in Babol, Northern Iran were entered into this case-control study. Healthy subjects in control group included individuals without history of DM. The patients were classified into four groups including I. Control (n=79), II. Diabetic patients without DR (n=68), III. Non-proliferative DR (n=61), and IV. Proliferative DR (n=64). Blood samples were collected, and necessary laboratory tests were performed.Results:The MPV value was significantly higher in each group of II, III and IV compared to group I (p<0.001). This value was also significantly higher in each group of III and IV compared to group II. On the other hand, there was no significant difference between III and IV groups in MPV. A significant correlation was found between MPV and fasting blood sugar in groups II (r=0.349, p=0.004), III (r=0.269, p=0.036) and IV (r=0.258, p=0.040). Moreover, there was a significant correlation between MPV and hemoglobin A1c in groups II (r=0.366, p=0.002), III (r=0.312, p=0.015) and IV (r=0.278, p=0.026).Conclusion:The results of this study showed that the increased MPV value was directly associated with DR and its severity. A positive association was also found between MPV and indicators of glycemic status. Considering that measurement of MPV as a suitable parameter reflecting platelet function can be easily conducted, it can be clinically used to monitor status of DR.

Koroner Arter Cerrahisi Geçiren Hastalarda İntravenöz Anestezi ve İnhalasyon Anestezisinin Kırmızı Hücre Dağılım Genişliği ve Ortalama Platelet Volümü Üzerine Etkileri

INTRODUCTION: The effects of midazolam-based intravenous anesthesia (TIVA) and sevoflurane-based inhalation anesthesia (SEVO) maintenance on postoperative hematological parameters were compared in patients undergoing coronary artery surgery. METHODS: The 100 patients included in the study were divided into two groups according to the anesthesia management: All patients' anesthesia inductions were performed with 10 μgkg-1 fentanyl, 0.15 mgkg-1 midazolam, and 0.8 mgkg-1 rocuronium. Anesthesia was maintained with total intravenous anesthesia in the TIVA group patients, while sevoflurane was used in the SEVO group patients. Demographic, clinical, operative data, red cell distribution width (RDW), and mean platelet volume (MPV) values were recorded. RESULTS: Except that the extubation time was shorter in the SEVO group, no difference was observed between the groups in terms of all these variables. There was a significant increase in postoperative RDW and MPV measurements in both groups. Postoperative RDW value was lower in the inhalation anesthesia group compared to the TIVA group (p=0.013). DISCUSSION AND CONCLUSION: In our study, RDW was found to be lower in the inhalation anesthesia group, indicating less inflammation. There was no difference in terms of postoperative complications and mortality.

Platelet morphological indices on Intensive Care Unit admission predict mortality in septic but not in non-septic patients.

Thrombocytopenia is associated with worse outcomes in critically ill patients. The clinical relevance of other platelets indices is less studied. We investigated the ability of the platelets distribution width (PDW) and the mean platelet volume (MPV) to predict mortality in critically ill patients. We hypothesized that the prognostic values of PDW and MPV could be different in septic and non-septic patients. We prospectively analyzed patients with an expected ICU length of stay ≥48 hours. Repeated measurements of PDW and MPV were considered (on ICU admission and up to day 5 thereafter). The primary outcome was to investigate the ability of PDW and MPV to predict 90-day mortality in septic and non-septic patients. We included in the study 234 patients of which 31% patients were septic. 90-day mortality was 39% in septic and 27% non-septic patients. PDW and MPV values on admission were 12.5±2.5% and 10.7±1.1 fL, respectively. The AUROC of PDW values on admission to predict 90-day mortality in septic patients was 0.813, being higher than those in non-septic patients (0.550, P<0.001). Similarly, the AUROC for MPV in septic patients was higher than non-septic patients (0.55, P<0.001). The combined analysis of platelets morphological indices and lactate improved the predictive accuracy (PDW and lactate AUROC=0.870; MPV and lactate AUROC=0.867). Platelet morphological indices are independent predictor of 90-day mortality in septic patients but not in non-septic patients. A combined analysis of platelets morphological indices and lactate in septic patients resulted in improved prediction of mortality.

Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers

Aim: Inflammation may have deleterious effects on tissue healing. Pressure ulcers impair the quality of life of the patients admitted to intensive care unit (ICU) besides increasing the health costs. Neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) are simple and readily available markers proinflammatory state. This study aimed to investigate whether measurement of admission NLR and MPV could be useful in identification of the patients who are at elevated risk for the development of the pressure ulcers. Methods: This retrospective cohort study evaluated 104 patients admitted to the intensive care unit of a tertiary center. Patients were divided into two groups according to the presence of pressure ulcers as follows: Patients without pressure ulcers throughout hospitalization and patients who developed pressure ulcers while hospitalized. The two groups were compared with respect to the demographic features and complete blood count parameters at admission. Results: The NLR [8.8 (6.6) vs. 5.3 (2.6), P<0.001], platelet to lymphocyte ratio [322(125) vs. 234(116), P=0.023] and MPV [10.5 (1.5) fl vs. 9.8 (1.1) fl, P<0.001] were significantly higher, and length of ICU stay was significantly longer in patients with pressure ulcers than those without [16.1 (3.8) days vs. 12.5 (2.9) days, P<0.001]. Logistic regression analysis revealed that age (P=0.03), length of ICU stay (P=0.01), NLR (P=0.01) and MPV (P=0.01) were significantly predictive for the presence of pressure ulcers. Conclusions: Our findings indicate that age, length of ICU stay, and NLR, and MPV, which are indicative for the preexisting inflammatory state, are independent predictors for the development of pressure ulcers in patients admitted to the ICU

Evaluation of complement system proteins C3a, C5a and C6 in patients of endometriosis

BackgroundEndometriosis is a disease that shows auto-immune and chronic characteristics, suggesting a role for proteins mediating immune interactions in its pathophysiology. The aim was to evaluate C3a and C5a for their role in inflammatory responses and C6 as the down-stream interactor following our previous findings on C5 mRNA expression changes in endometriosis [1]. MethodsSera from 71 endometriosis patients and 77 women without endometriosis were taken. While the samples were taken only once from the controls, the patient samples were taken before, in 1st and in 7th days after laparoscopy. Levels of complement proteins C3a, C5a and C6 were measured with ELISA assays. MPV (Mean Platelet Volume), CRP (C-Reactive Protein) and NLR (Neutrophil-to-Leukocyte Ratio) were also analyzed from the retrospective data. ResultsC6 levels of early-stage patients at postoperative 1st day were significantly higher than controls. Patients with high MPV measurements had significantly higher C3a (p < 0.0001) and C6 (p < 0.05) levels than controls at all times of measurement. ConclusionsC6, an integral component of the membrane attack complex (MAC), could play a role at early disease-stage. The changes in levels of complement proteins and their relation to high MPV levels suggest a broader area of interplay for immune interactors in endometriosis. Although a bigger and longitudinal study design is needed to obtain more accurate results to evaluate these proteins as potential biomarkers, an important role of complement system within the pathophysiology of endometriosis is apparent.

Increased Mean Platelet Volume is Associated with Decreased Survival in Patients Supported with Impella

Increased mean platelet volume (MPV) has been associated with elevated risk of stroke and myocardial infarction in the general population and stroke/pump thrombosis in Heartmate II recipients. It has been proposed that contact with foreign surfaces and centrifugation promote prothrombotic states with platelet activation and increased MPV. An association between MPV and outcomes of patients treated with percutaneous short-term circulatory devices has not been investigated. This was a retrospective study of 67 patients who received percutaneously inserted ventricular assist device (pVAD) support for high risk percutaneous coronary interventions. Mean platelet volume (MPV) was measured by impedance technology with Sysmex XN-10 hematological analyzer and expressed in femtoliters (fL). Average MPV (aMPV) and percentage change from admission (∆MPV%) were calculated. All patients experienced rise in MPV during the hospital stay (10.7+/-0.9 pre-pVAD, 10.8+/-0.8 in 24hrs post pVAD, and 11.1+/-1 fL at 7d, p<0.0001). However, MPV increase was more pronounced in the 24 patients (34.5%) who expired in the hospital (Figure A) and the ∆MPV% was significantly higher in expired patients (7.7+/-7.8 vs. 4.6+/-4.9% in survivors, p=0.026). When adjusted for clinical variables (age, gender, and histories of atrial fibrillation, hypertension, coronary artery disease, and congestive heart failure), every 1% increase in ∆MPV% was associated with 11% increased odds of dying in patients undergoing high risk PCI with pVAD support (OR 1.111, 95%CI 1.015-1.216, p=0.022). This pilot study indicates that rise in MPV is associated with increased mortality in PCI patients treated with pVAD. Simple and widely available MPV measurements may be useful in identifying high risk patients and estimating prognosis, which may aid in proper resource allocation. More studies on this subject are necessary.

Changes in mean platelet volume in the course of upper gastrointestinal bleeding

In this study, we retrospectively evaluated patients with upper gastrointestinal bleeding (UGB) who were followed up at our center over a 3 year period and aimed to determine the factors affecting mean platelet volume (MPV) in patients with UGB, temporal changes in MPV during UGB, and the relationship between MPV values and the severity of UGB. Patients and methods: A total of 170 patients who were hospitalized between January 2010 and December 2013 with a diagnosis of UGB, completed a 72-hour follow up, and had a baseline blood count performed within 6 months were evaluated retrospectively. Demographic, clinical, and laboratory data, along with MPV values at baseline, on admission, and at 4 hours, 1 day, 2 days, 3 days, and discharge, were evaluated. Number Cruncher Statistical System (NCSS) 2007 was used for statistical analyses. Results: Women and patients with comorbid diseases had higher baseline MPV values; this effect disappeared after admission for UGB and reappeared at discharge. MPV values were lowest at the start of the bleeding and significantly increased during the course of UGB. Baseline MPV and MPV at discharge values were similar. There was no statistically significant relationship between any MPV measurement and transfusion amount. Conclusion: The effects of gender and comorbid diseases were negated by the presence of UGB and returned after UGB was controlled. MPV levels exhibited temporal changes during the course of UGB, indicating that MPV can be used as a marker; however, no statistical relationship was found between temporal MPV values and transfusion amount, a marker for UGB severity.

Assessment of bronchial asthma exacerbation: the utility of platelet indices

BackgroundActivated platelets and platelet indices have a vital role in bronchial hyper-responsiveness, bronchoconstriction, bronchial inflammation, airway remodeling, angiogenesis, allergic reactions, and repair and renewal of tissues; platelets contain mediators that lead to inflammatory response.AimThe aim was to assess the use of platelet indices [mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet large cell ratio (PLCR)] as cheap and readily available biomarkers for bronchial asthma exacerbation.Patients and methodsA case–control study involved 45 bronchial asthma female patients during both stable and exacerbation phases, and 45 age-matched healthy female patients as a control group. Measurements of platelet counts, MPV, PDW, PCT, PLCR, C-reactive protein (CRP), spirometric indices, and arterial blood gases were performed for all participants.ResultsThe MPV and PDW were significantly lower, whereas the PCT and PLCR were considerably higher in exacerbation phase compared with stable phase and in stable phase in comparison with controls (P<0.001). The MPV and PDW were negatively correlated with white blood cells, PaCO2, symptoms duration, and hs-CRP (high sensitive), with positive correlation with forced expiratory volume in the first second and PaO2 (P<0.001). PCT and PLCR were positively correlated with white blood cells, PaO2, and symptoms duration, and negatively correlated with forced expiratory volume in the first second, symptoms duration, and hs-CRP (P<0.001).ConclusionThe platelet indices were altered in exacerbation phase compared with stable phase and control group. Therefore, clinicians should not ignore interpreting platelet indices during asthma exacerbation, especially as these tests are simple, readily available, and of lower cost. It appears that measurement of the platelet indices is a valuable indicator of asthma severity/activity and appears as a useful screening test for asthma exacerbation.