Plateletcrit Values Research Articles

The role of thrombocyte indices in early determination of sepsis agents in newborns

Purpose: Neonatal sepsis is an important cause of morbidity and mortality. The signs and symptoms of neonatal sepsis are nonspecific, and there is no ideal marker for diagnosis. Our study aimed to investigate the role of platelet indices in determining agents in sepsis. Materials and Methods: A total of 90 records with sepsis data were examined retrospectively, demographic and clinical characteristics of gram-positive, gram-negative and Candida infection patients were evaluated by complete blood counts at the time of diagnosis and on the fifth day of infection and platelet amount (PLT), mean platelet volume (MPV), plateletcrit (PCT) and distribution width (PDW) values were compared by ROC curve analysis. Results: No statistical difference was found between the groups in terms of gender, gestational week, birth weight, surfactant use, need for mechanical ventilator treatment, and necrotizing enterocolitis. When infection was first detected, the Area Under Curve (AUC) of PCT, PLT and MPV (without thrombocytopenia) values in detecting gram-positive bacterial infection were 0.764, 0.765 and 0.792 respectively. Conclusion: The increase in PCT and PLT values at the time of initial diagnosis can be used to detect gram-positive bacterial infections. A decrease in MPV can be used for early diagnosis of fungal infections without thrombocytopenia.

Predictive values and relationships of serum PSA levels, delta neutrophil index, neutrophil-lymphocyte ratio and other hematological parameters in patients with acute prostatitis.

This study aimed to evaluate the predictive values and relationships of serum prostate-specific antigen (PSA) levels, delta neutrophil index (DNI), neutrophil-lymphocyte ratio (NLR), and other hematological parameters in patients diagnosed with acute prostatitis. Serum PSA levels and hemogram parameters of patients diagnosed with acute prostatitis were retrospectively analyzed. Healthy patients of the same age group were assigned to the control group. WBC, neutrophil, lymphocyte, thrombocyte (PLT), mean platelet volume (MPV), plateletcrit (PCT), NLR, and DNI were determined. Serum total PSA and C-reactive protein (CRP) levels were also assessed. Total PSA levels (3.48 [1.11-6.66]) in the acute prostatitis (AP) group were significantly higher than those of healthy men (0.82 [0.47-1.39]) (p < 0.001). Total CRP levels (3.88 [1.50-22.03]) in the AP group were significantly higher than those in healthy men (1.15 [0.89-2.00]) (p < 0.001). The sensitivity and specificity of PSA at a cutoff value of 1.52 were 68.4% and 79.7%, respectively. The NLR value in the AP group was 2.62 (1.87-4.42), compared to 1.63 (1.18-2.20) in the healthy group (p < 0.001). Differences in WBC, neutrophil, and lymphocyte counts were also statistically significant (p < 0.001). There were no significant differences in PLT, PCT, or DNI values. Significant positive correlations were observed between PSA, CRP, and DNI values (all p < 0.001). This study demonstrated the usefulness of NLR, PSA, CRP, and WBC as predictors of acute prostatitis. NLR is a simple, inexpensive inflammation parameter that correlates well with CRP levels.

The association between heparin sensitivity index and postoperative blood loss in Chinese patients undergoing elective off-pump coronary artery bypass grafting: a single center retrospective study

BackgroundThe heparin sensitivity index (HSI) is closely associated with perioperative ischemic events and increased blood loss in cardiac surgery. Previous studies have produced conflicting results. Therefore, this study aimed to investigate the relationship between HSI and postoperative blood loss specifically in Chinese patients undergoing elective off-pump coronary artery bypass grafting (OPCAB).MethodsPatients underwent OPCAB between March 2021 and July 2022 were retrospectively included. Enrolled patients were classified into Low-HSI (HSILOW; HSI < 1.3) and Normal-HSI (HSINORM; HSI ≥ 1.3) groups. HSI = [(activated clotting time (ACT) after heparin) – (baseline ACT)] / [loading dose of heparin (IU/kg)]. Primary outcome included postoperative blood loss at 24 h. Secondary outcomes were total postoperative blood loss, transfusion requirement of red blood cell (RBC), fresh frozen plasma (FFP), platelet concentrates (PC), and other complications.ResultsWe retrospectively analyzed 303 Chinese OPCAB patients. HSILOW group had higher preoperative platelet (PLT) count (221 × 109/L vs. 202 × 109/L; P = 0.041) and platelet crit (PCT) value (0.23% vs. 0.22%; P = 0.040) compared to HSINORM group. Two groups showed no significant differences in postoperative blood loss at 24 h (460 mL vs. 470 mL; P = 0.252), total blood loss (920 mL vs. 980 mL; P = 0.063), RBC transfusion requirement (3.4% vs. 3.1%; P = 1.000), FFP transfusion requirement (3.4% vs. 6.2%; P = 0.380), and other complications. Preoperative high PLT count was associated with low intraoperative HSI value (odds ratio: 1.006; 95% confidence interval: 1.002, 1.011; P = 0.008).ConclusionsIntraoperative HSI value was not associated with postoperative blood loss in Chinese patients undergoing OPCAB. Preoperative high PLT count was an independent predictor of low intraoperative HSI value.

Evaluation of hematological inflammatory parameters in patients with palmoplantar pustulosis.

Palmoplantar pustulosis (PPP) is a chronic inflammatory disease of ill-defined etiopathology. Recent studies have proposed complete blood count-based hematological parameters, such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), as biomarkers to monitor disease status in many inflammatory diseases. This study aimed to analyze for the first time the clinical significance of hematological parameters, including NLR, monocyte/lymphocyte ratio (MLR), PLR, mean platelet volume (MPV), plateletcrit (PCT), and pan-immune-inflammation value (PIV) in PPP patients. We retrospectively investigated the clinical and laboratory data of 237 patients with PPP and 250 sex-age-matched healthy controls (HCs). Hematological parameters were compared between patients with PPP and HCs. The correlations between these parameters and disease severity, as well as treatment response, were analyzed. NLR, MLR, MPV, PCT, and PIV values were significantly higher in PPP patients than in HCs. But in receiver-operating characteristic analyses, only monocyte count (Youden Index = 0.53), PCT (Youden Index = 0.65), and PIV (Youden Index = 0.52) performed relatively accurate distinguishment between moderate-to-severe cases and mild cases. PCT and PIV values were significantly correlated with disease severity. After treatment, both PIV and PCT values decreased significantly in the responder group but not in the non-responder group. Hematological parameters altered significantly in PPP patients. PCT and PIV can be used as simple and inexpensive biomarkers for systemic inflammation in PPP patients.

Correlation between platelet indices and preeclampsia with severe features

Backgrounds: Pre-eclampsia is a pregnancy-related syndrome with a 2-8% prevalence worldwide. In Indonesia, its incidence was 128,273 (5.3%) cases that caused 30-40% of maternal deaths. In 2021, at Karawang General Public Hospital, there are 43% cases of pre-eclampsia with 3% of complication. The pathophysiology is related to the inflammatory and coagulation system that includes platelets. Thus, platelet indices as indicators for platelet changes could be potential laboratory markers for pre-eclampsia.Objective: To examine the relationship between the platelet indices and pre-eclampsia severe features at the Karawang General Public HospitalMethods: The six months cross-sectional study was conducted at the Karawang General Public Hospital for pre-eclampsia pregnant women with at least 28 weeks of gestational age. The pre-eclampsia criteria were blood pressure higher or equal to 140/90 mmHg and qualitative proteinuria dipstick +1. The subjects were divided into two groups: pre-eclampsia with severe features and without severe features. Severe features criteria were thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, new onset headache, and visual disturbances. Pregnant women have their blood platelet indices checked in the form of platelet crit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR). Data were analyzed with descriptive analysis (percentage), cut-off analysis, ROC curve, AUC analysis, bivariate Chi-square analysis, and multivariate logistic regression analysis.Results: There was a significant difference (p &lt; 0.05) in the value of PCT, MPV, PDW, and P-LCR between pregnant pre-eclampsia women with severe features and pregnant pre-eclampsia women without severe features. P-LCR has the best sensitivity (52.9%) and specificity (98.9%).Conclusions: There was a significant change in the value of the platelet indices (PCT, MPV, PDW, P-LCR) in pregnant pre-eclampsia women with severe features at the Karawang General Public Hospital.

The role of inflammation markers in occurrence of radial artery occlusion.

Aim: Radial artery occlusion (RAO) is a major complication of catheterization via transradial access (TRA). Our aim is to reveal the ability of high-sensitive C-reactive protein (hs-CRP) and complete blood count (CBC) components, which are inflammation markers, to predict RAO. Methods: Patients were divided into two groups: 103 with RAO and 300 without RAO. The relationship between CRP, CBC components and RAO was evaluated. Results: A significant increase in hs-CRP, monocyte, platelet (PLT), platelet distribution width (PDW) and plateletcrit values was observed after TRA, and only the increase in PDW, PLT and hs-CRP was found to be independent determinants in regression analysis. Conclusion: High PDW and PLT and increased hs-CRP levels are new independent determinants of the development of RAO.

Correlation between change in platelet count and platelet indices in cases of acute ischemic stroke in tertiary care centre of northern India

Background: Platelet is the important factor in the pathogenesis of atherosclerotic complications, contributing to thrombus formation. As there is a significant correlation found between acute ischaemic stroke and platelet indices including platelet count with their prognostication, but no similar study has been documented from this area of the country, which has drawn attention to conducting this study. Methods: This is an observational, case-control study. Patients with acute ischaemic stroke and aged 18 years or above were included involving a total of 156 subjects (78 cases and 78 controls). They were examined clinically radio-logically and pathologically by platelet count and different indices like mean platelet volume (MPV), platelet distribution width (PDW), platelet to large cell ratio (P-LCR). Results: In the present study, mean PDW of cases is 17.69 fl with a SD of 3.22 fl and means PDW of the control group is 13.67 fl with a SD of 3.15 fl. There is statistically insignificant (p=0.26, CI-95%) changes in value of plateletcrit (PCT) among cases and control group (mean PCT of cases is 0.27% with a SD of 0.O7% and the mean PCT of control subjects is 0.29% with a SD of 0.07%). Conclusion: The observations here suggest a role for larger platelets in the genesis of cerebral thrombosis and are likely to represent changes occurring at the time of thrombopoiesis. Patients with larger platelets can easily be identified during routine haematological analysis. Hence, these indices serve as an important and cost-effective tool in predicting an impending ischemic event and can be used in the future, especially in resource poor countries like India. Keywords: mean platelet volume; platelet count; cerebrovascular accident; platelet distribution width; plateletcrit

Correlation of Platelet Parameters With the Severity of Thrombocytopenia in Dengue Fever in Children Aged Less Than 18 Years at a Tertiary Care Centre: A Cross-Sectional Study.

Introduction Dengue is a tropical viral disease caused by dengue virus with varied severity ranging from dengue fever to dengue shock syndrome. In dengue infection, there is thrombocytopenia with platelet activation. According to various proposed theories, activation of platelets during thrombocytopenia leads to changes in platelet parameters like mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet index (PI). So,this study was conducted to correlate platelet parameters with the severity of thrombocytopenia in children with dengue fever at a tertiary care hospital. Methods An observational cross-sectional study was conducted on 72 children below 18 years admitted with dengue infection at a tertiary care hospital. All 72 patients were divided into three groups depending on platelet count. Group I included individuals with a platelet count less than 50000/mm3, while group II comprised patients with platelet counts ranging between 50001/mm3 and 100000/mm3, and group III encompassed individuals with platelet counts exceeding 100001/mm3. Platelet parameters like MPV, PDW, PCT, and PI were analyzed on day one and day three of admission. These parameters on day one and day three were correlated with the severity of thrombocytopenia in all three groups. Results PCT values on day one and day three were statistically significant (p<0.05) in all three groups with p-value <0.001 withprofound positive correlation, which means PCT value decreases with increasing severity of thrombocytopenia. PI in group I was statistically significant on day one (p=0.009) but not on day three (p=0.063). PI in group II was statistically significant(p<0.05) on day three (p=0.002), while in group III, PI was significant statistically on day one (p<0.001). MPV in group I, on day one(p=0.006) and in group II, on day three(p= 0.049) were statistically significant(p<0.05).PDW was statistically significant only on day one (p=0.031) in group I, while was not significant in groups II and III. Conclusion MPV, PDW, and PCT increasewith a decrease in platelet count, whereas there isan increase in PI. These platelet indices could be used to predict the severity of thrombocytopenia and severity of the dengue fever. Along with MPV and PDW, PCT could be used to assess the severity of the disease progression.

Effectiveness Of Platelet Markers In Estimating The Amount Of Intraoperative Bleeding In Vertebra Surgery

AIMS: One of the most important steps in perioperative bleeding management is the predetermination of the patient at risk. Even if there is no hemostatic abnormality in vertebral surgery, which is a major surgery, severe bleeding can be encountered and many perioperative blood transfusions might be required. To date, there are no studies in the literature examining platelet markers in terms of predictivity in intraoperative bleeding during vertebral surgeries. In this study; we investigated the effectiveness of preoperative mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), mean platelet volume lymphocyte count ratio (MPVLR), and platelet count to lymphocyte count ratio (PLR) values in predicting the amount of intraoperative bleeding in patients who will undergo vertebral surgery. &#x0D; METHODS: After the approval from the ethics committee, patients who were planned for vertebral surgery by the neurosurgeon were identified. Patient demographic data such as gender, age, ASA score and body mass index (BMI), MPV, PDW, PCT, MPVLR, and PLR values were recorded. Total surgery time, the number of vertebral transpedicular screwing, and laminectomy levels performed as surgical procedures were recorded. The amount of intraoperative bleeding was determined by calculating the amount of blood accumulated in the aspirator and the amount of blood collected by the sponge during surgery. &#x0D; RESULTS: Of the 63 patients included in the study, 60.3% (n=38) were female and 39.7% (n=25) were male. The mean age of the patients was 54.7 ± 11 years and the mean BMI was 29.6 ± 4.6. No correlation was found between the amount of bleeding and gender, age, MPV, PDW, PCT, MPVLR, or PLR values. A significantly high correlation was found between amount of bleeding and BMI, duration of surgery, and the number of transpedicular screwing segments. &#x0D; CONCLUSION: Platelet markers do not appear to have an effect on the amount of bleeding. However, as the BMI increases, the duration of surgery prolongs and the number of transpedicular screw segments increases for which the amount of bleeding increases.

The Impact of Plateletcrit on the Diagnosis and Management of Gestational Diabetes Mellitus

Aim: Gestational diabetes mellitus (GDM) is a condition that can cause serious maternal and fetal complications. Platelets are one of the cells that play an important role in inflammation in our body. In this study, we aimed to investigate whether there is a relationship between platelet values obtained by a simple blood count and GDM. Materials and Methods: Two groups consisting of 60 individuals with GDM and 250 healthy populations were created. Demographic characteristics, the sugar loading test results performed between 24th-28th weeks and simple complete blood count results including platelets, plateletcrit (PCT), platelet distribution width (PDW), and mean platelet volume (MPV)) were analyzed with SPSS. Results: When comparing the ages, BMI, average blood pressure, heights, and gestational weeks of both groups, there was no any significant differences (p&gt;0.05). In terms of the hemoglobin, platelet, and white blood cell counts, there wasn’t any significant differences between the two groups (p&gt;0.05). MPV, PDW and PCT values were significantly increased in patients with GDM compared to healthy pregnant women (p&lt;0.02, p&lt;0.009, and p&lt;0.001, respectively). Specifically, there was a significant positive correlation was found between PCT and the 1st hour glucose level (r: 0.585, p=0.001). Conclusion: We predict that a simple blood count (especially MPV, PDW and PCT values) performed during the first routine visit of pregnant women may be useful in predicting the risk of GDM.

Platelet-associated biomarkers in nonalcoholic steatohepatitis: Insights from a female cohort with obesity.

There is a lack of noninvasive diagnostic methods for nonalcoholic steatohepatitis (NASH), the severe condition of metabolic dysfunction-associated steatotic liver disease (MASLD). Platelet activation, evaluated through certain related parameters, is associated with liver disease and inflammation, but previous results are inconclusive. To investigate the potential utility of platelet-related indices as noninvasive diagnostic markers for the detection and prediction of MASLD, focusing on NASH. We found that mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW) were increased in the severe and morbidly obese (SMO) group compared to the normal weight (NW) group. We found decreased levels of MPV in steatosis and NASH patients. MPV and PCT values were decreased in the presence of mild liver inflammation. Platelet count (PLA) and PCT values were lower in the presence of ballooning. We obtained an area under the ROC curve of 0.84 using MPV and three other variables to predict MASLD. Some platelet-related indices vary depending on liver condition. Here, we reported decreased MPV in MASLD presence. Moreover, we presented for the first time a predictive model using MPV, ALT levels and the presence of diabetes mellitus and metabolic syndrome to predict MASLD in obese women. Also, MPV is closely related to early liver inflammation in NASH, and PLA and PCT are related to hepatic ballooning. These indices could be widely used for the early detection of NASH since they are usually determined in routine laboratory tests.

Can Red Blood Cell and Platelet Parameters Be Associated With Inflammation in Children With Tic Disorder?

Tic disorder (TD) is one of the neurodevelopmental disorders and its etiology has not been fully elucidated. Complete blood count (CBC) values have been used as indicators of a systemic inflammatory response. In our study, we aimed to assess hemogram parameters in drug-naive, comorbidity-free children with TD compared with controls. This retrospective study included 62 drug-naive children with TD who had undergone CBC within one month prior to the study. A control group of 48 healthy children, matched for age and gender, without any organic or psychiatric disorders, was included. Statistical analysis was performed by using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, New York, United States). Results: Hematocrit (p = 0.044), mean corpuscular volume (p = 0.002), platelet count (p = 0.011), and plateletcrit (p = 0.031) values were significantly higher in the TD group, whereas mean corpuscular hemoglobin concentration (p = 0.00) was significantly lower in the TD group. Additionally, a significant negative correlation was observed between the duration of illness and platelet (p = 0.05, r=-0.282), plateletcrit (p = 0.038, r = -0.295), and neutrophil count (p = 0.006, r = -0.391), while a positive correlation was found between the duration of illness and eosinophil count (p = 0.018, r = 0.336). The results revealed several significant differences in hemogram parameters between TD patients and the control group. These may suggest the role of inflammation and/or other underlying mechanisms in TD and may inspire new studies. Future studies with larger and more homogeneous samples, including comprehensive inflammatory markers, may contribute to a deeper understanding of the relationship between inflammation and TD.

Effect of isotretinoin treatment on inflammatory and hematological parameters in patients with acne vulgaris

Purpose Although the inflammatory and anti-inflammatory effects of isotretinoin (ISO) treatment in patients with acne vulgaris have been discussed in the literature in recent years, no sensitive and specific marker has been found in studies so far. Neutrophil/HDL (high-density lipoprotein) (NHR), lymphocyte/HD L(LHR), platelet/HDL (PHR), and lymphocyte/monocyte (LMR) are new biomarkers related to inflammation. Triglyceride/HDL (TG/HDL), LDL/HDL, and total cholesterol/HDL have been shown to be cardiometabolic risk factors predicting both cardiovascular disease risk and metabolic risk, rather than just a simple dyslipidemia scale. To our knowledge, the relationship between these parameters and ISO treatment has never been studied before. We aimed to evaluate the immuno-inflammatory response of ISO treatment in patients with acne vulgaris with NHR, LHR, PHR, LMR, TG/HDL, LDL/HDL, and total cholesterol/HDL parameters. Materials and methods In this study, 153 patients who received oral ISO treatment for at least 3 months with a diagnosis of moderate-severe acne vulgaris were evaluated retrospectively. Patients were given oral isotretinoin at a dose of 0.5–1 mg/kg. Pre and post-treatment leukocyte (WBC), neutrophil (NE), lymphocyte (LY), platelet (PLT), red cell distribution width (RDW), plateletcrit (PCT), neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), mean platelet volume (MPV), monocyte/lymphocyte (MLR), LMR, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, MHR, NHR, LHR, PHR, TG/HDL, total cholesterol/HDL, LDL/HDL parameters were evaluated. Results It was found that post-treatment WBC and MPV values increased statistically significantly; NLR, neutrophil, and PCT values, on the other hand, decreased significantly (p < 0.05). No statistically significant change was detected in PLR, MLR, LMR, MHR, NHR, LHR, PHR, lymphocyte, monocyte, platelet, and RDW parameters (p > 0.05). It was determined that post-treatment total cholesterol, triglyceride, VLDL, and LDL levels increased statistically significantly; however, the HDL level decreased significantly (p < 0.05). Levels of total cholesterol/HDL, TG/HDL, and LDL/HDL were also found to increase statistically significantly (p < 0.05). Conclusion Our study suggests that the MPV and NLR ratio as biomarkers can be used as indicators of atherosclerosis-related inflammation due to ISO treatment, but the MHR, NHR, LHR, PHR, MLR, LMR ratios cannot be used. Moreover, we believe that the ratios of TG/HDL, LDL/HDL, and total cholesterol/HDL offer a new contribution as indicators of cardiovascular risk and systemic inflammation related to ISO treatment.

Evaluation of plateletcrit level from platelet indices as a prognostic marker in COVID-19 patients.

COVID-19 disease bears similarities to a wide range of diseases, from simple flu infections to severe acute respiratory distress syndrome and is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this study, we aimed to elucidate the plateletcrit levels in patients with and without mortality who had been admitted to the intensive care unit because of pneumonia associated with SARS-CoV-2. In total, 434 patients were evaluated in this retrospective analysis. Their demographic data, comorbid diseases, Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, platelet, lymphocyte, white blood cell (WBC) and neutrophil counts; mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), hemoglobin and C-reactive protein (CRP) levels and neutrophil-lymphocyte ratios (NLRs) were obtained from the hospital's electronic database on the days of the patients' intensive care unit admissions. Afterwards, their PLR, PNR, and MPV/PLT ratios were calculated. APACHE II score, length of hospital stay, WBC count, PCT, PLR, NLR, and CRP levels affected mortality. Increases in hospital stay duration, APACHE II score, platelet-lymphocyte ratio (PLR), and CRP, as well as decreases in PCT percentage, were associated with mortality. ROC curve analysis was performed to determine the success of PCT, PLR, and NLR in predicting mortality in COVID-19 patients and to determine cut-off values for mortality. It was determined that PCT, PLR, and NLR could correctly classify patients at rates of 58.9%, 59.2%, and 66.8% (moderate), respectively. The risk of mortality was higher in patients with PCT values of 0.188 or less, PLR values greater than 293.46, and NLR values greater than 9.49. In the COVID-19 patients evaluated in this study, plateletcrit indices could be utilized to predict mortality.

The İmportance of hematological parameters in the prognosis of patients with severe COVID-19, A single-center retrospective study.

Inflammation biomarkers known as acute phase reactants (APRs) show significant variations in serum concentrations during inflammation brought on by both viral and noninfectious diseases. The erythrocyte sedimentation rate (ESR), the C-reactive protein (CRP), the lactate dehydrogenase (LDH), the ferritin, the fibrinogen, the procalcitonin, the D-dimer, and the troponin I are all significant APRs. During inflammation, the serum levels of each of these positive APRs rise. The sensitivity and specificity of hematologic parameters and indices are as high as the inflammatory biomarkers mentioned above for monitoring disease severity and treatment response. We aimed to evaluate the differences in hematological parameters and indices, and to reveal their treatment and prognostic values, especially in deceased patients with COVID-19. The hemogram parameters of 169 critical patients with COVID-19 (125 males and 44 females) who received inpatient treatment at …. Analyses of the hematological parameters used during the treatment processes revealed statistically significant differences between the two patient groups. White blood cell (WBC), neutrophil, and neutrophil-to-lymphocyte ratio (NLR) values were significantly higher (P = 0.019, P = 0.000 and P = 0.000, respectively) for deceased subjects, while lymphocyte, platelet and plateletcrit (PCT) values were significantly lower (for all values, P = 0.000). Platelet volume (MPV) and platelet distribution width (PDW), as well as MPV/PLT, PDW/PLT, MPV/PCT, and PDW/PCT, levels were significantly higher in deceased subjects (P = 0.000). Particularly in our deceased cases, receiver operating characteristic analyses were performed to reveal the importance of such analyses in prognostic status evaluation in COVID-19 since the hematological parameters are quite different. Cut-off values were determined for each parameter, and sensitivity and specificity ratios were calculated. While the sensitivities of MPV/PLT, PDW/PLT, MPV/PCT, and PDW/PCT indices are over 80%, neutrophil and white blood cell sensitivities were found to be lower (74%, 68.8%, respectively). In addition to NLR, which is an important biomarker, the hematological indices MPV/PLT, PDW/PLT, MPV/PCT, and PDW/PCT can be used to determine the risk of death in patients with severe COVID-19.

Platelet indices as a predictor in the differentiation of Behçet's disease from recurrent aphthous stomatitis.

The aim of this retrospective cohort study was to investigate complete blood count parameters in patients with Behçet's disease (BD) who present with oral ulcers and patients with recurrent aphthous stomatitis (RAS) in order to determine whether they could be used as discriminatory biomarkers. This study was conducted between January 2019 and January 2023. The study population consisted of three groups: patients with BD who had oral ulcer manifestation (n=85, BD-Group), patients with idiopathic RAS (n=186, RAS-Group) and healthy controls (n=90, HC-Group). All data about participants, on their first application, including sociodemographic and clinical data, comorbidity status, laboratory results were collected retrospectively from the hospital computer records and patients' charts. The groups were similar in terms of age (p=0.235) and sex distribution (p=0.450). Mean platelet volume (MPV) and plateletcrit values of the BD-Group were significantly lower, while platelet distribution width (PDW) was significantly higher, compared to the other two groups (p<0.001 for all). Low MPV (<9.15) (56.47% sensitivity and 90.86% specificity), high PDW (≥15.75) (75.00% sensitivity and 94.96% specificity) and low plateletcrit (<0.237) (55.29% sensitivity and 79.46% specificity) could significantly distinguish BD patients with oral ulcer onset from patients with RAS. PDW, MPV, and plateletcrit may be useful biomarkers in the differential diagnosis of oral ulcers when distinguishing between BD and RAS. However, these results need to be supported by further comprehensive studies.

Analysis of the predictive value of plateletcrit for the degree of liver fibrosis in patients with chronic HBV infection with ALT less than two times the upper limit of normal

Objective: Plateletcrit (PCT) is considered a new potential index to predict the degree of liver fibrosis in patients with chronic hepatitis B (CHB). This study aimed to explore the predictive value of PCT for the degree of liver fibrosis in patients with chronic hepatitis B virus (HBV) infection with alanine aminotransferase (ALT) < 2× upper limit of normal (ULN). Measurement data were compared using the t-test, ANOVA, or non-parametric test (Mann-Whitney U test). Categorical variables were compared using χ (2) test or Fisher's exact test. Methods: 140 cases with chronic HBV infection who underwent liver biopsy and ALT < 2×ULN were enrolled from January 2016 to March 2021. Univariate and multivariate logistic regression and the area under the receiver operating characteristic curve (AUC) were used to determine the predictive value of PCT for the degree of liver fibrosis. The likelihood ratio (LR) was used to optimize the selection of the diagnostic cut-off. Results: (1) Among the 140 cases, there were 34 (24.3%) cases in the S0 stage, 47 (33.6%) cases in the S1 stage, 16 (11.4%) cases in the S2 stage, 19 (13.6%) cases in the S3 stage, and 24 (17.1%) cases in the S4 stage. The overall mean PCT level was 0.19 ± 0.06%. (2) Univariate analysis revealed that PCT between patients with stages of liver fibrosis was S(0-1) and S(2-4) (0.20% ± 0.05% vs. 0.16% ± 0.06%, t = 3.955, P < 0.001), S(0 -2) and S(3-4) (0.20% ± 0.05% vs. 0.15% ± 0.06%, t = 5.631, P < 0.001) and S(0-3) and S4 (0.20% ± 0.05% vs. 0.12% ± 0.05%, t = 7.113, P < 0.001), respectively, and the differences were statistically significant. Multivariate logistic regression analysis showed that PCT was an independent risk factor for liver fibrosis stages S(2-4), S(3-4), and S4 (OR = 0.925, 95% CI: 0.859 - 0.997, P = 0.042; OR = 0.867, 95% CI: 0.789 - 0.954, P = 0.003; OR = 0.708, 95% CI: 0.593 - 0.846; P < 0.001). (3) The AUCs of PCT were 0.702, 0.777, and 0.885 for diagnosing liver fibrosis stages S(2-4), S(3-4), and S4 in patients with chronic HBV infection with ALT < 2×ULN. PCT was superior for the cirrhosis (S4) diagnosis. 92 (65.7%) cases were diagnosed as cirrhosis or non-cirrhosis according to the LR optimized diagnostic and exclusion diagnostic cut-offs (≤0.09%, ≤0.17%), with an accuracy of 97.8%. Conclusion: PCT has a high diagnostic and exclusion value for cirrhotic patients with chronic HBV infection with ALT < 2×ULN. Furthermore, it can be used as a non-invasive diagnostic index for determining and assisting the diagnosis of cirrhosis in resource-constrained areas, reducing the need for pathological examination of liver biopsies, and it has the advantage of being simple and intuitive without complex calculations.

A simple proof of vitamin D deficiency and inflammation relation: single center study, over two thousand patients

Aim: Vitamin D deficiency is a very common condition in the world. Although vitamin D appears to be effective mainly on calcium and bone metabolism, it is an important molecule that also affects immune functions and inflammation. In our study, we tried to evaluate the contribution of vitamin D deficiency to inflammation by examining the platelet indices of patients with low and normal vitamin D levels. Methods: Healthy patients who applied to internal medicine outpatient clinics of our hospital for routine control in 2017 were included in our study. Patients are included in the study by following needed criteria; creatinine &amp;lt;1.3 mg/dl, hemoglobine &amp;gt;12 gr/dl, vitamin B12 &amp;gt;150 pg/dl, red cell distribution width &amp;lt;14 fL, thyroid stimulating hormone (TSH) between 1-5 IU/L and C-reactive protein (CRP) &amp;lt;10 mg/dl. Patients were divided into two groups, those with vitamin D less than 10 ng/ml as the study group and those above 30 ng/ml as the control group. Results: A total of 2179 patients, 644 male and 1535 female, were included in the study. 797 patients constituted the study group (27.1% male), and 1382 patients constituted the control group (31% male). When the two groups were compared in terms of platelet indices, we found that mean platelet volume (MPV) and plateletcrit (PCT) were significantly higher in the study group (p&amp;lt;0.001, p&amp;lt;0.001). Conclusion: In our study, we found that MPV and PCT values increased significantly with vitamin D deficiency. We attributed this result to the absence of the anti-inflammatory activity of vitamin D. As a result, treating a patient’s vitamin D deficiency can also protect patients from cardiovascular or autoimmune diseases through the anti-inflammatory effect of vitamin D.

Can Propranolol Affect Platelet Indices in Infantile Hemangioma?

Propranolol, a nonselective beta-blocker used in the medical treatment of infantile Hemangioma (IH), has been shown to decrease the levels of vascular endothelial growth factor and reduce angiogenesis with its antiproliferative and antiangiogenetic effects. It has been reported that the storage, transport, and secretion of vascular endothelial growth factor (VEGF) are associated with platelet volume indices (PVI). We aimed to investigate the effect of propranolol on PVI in IH patients. Propranolol treatment was started on 22 IH patients. Platelets, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit values in the follow-ups at months 0, 1, and 2 were compared between 22 patients who received treatment and 25 patients who did not. While a statistically significant difference between months 0, 1, and 2 in PDW and MPV values was detected in the treated group, it was not detected in the untreated group. Taking into consideration that VEGF levels were higher at the beginning of the treatment in the pathophysiology of the disease, it was thought that the decrease in VEGF levels by propranolol may have led to a decrease in MPV and PDW levels in the treatment group. Consequently, in IH cases, propranolol response follow-up can be evaluated with PVIs, especially MPV and PDW, and it may facilitate clinicians' monitoring of the disease after propranolol administration.

Plateletcrit is a Useful Marker in the Quality of Life Assessment of Patients with Rheumatoid Arthritis: A Cross-Sectional Study from Erbil, Iraq.

In patients with rheumatoid arthritis (RA), hematological indices and ratios have been reported to be related to the severity of illness, and thus could potentially be useful determinants of quality of life (QoL). To evaluate the association between hematological indices or ratios, which serve as biomarkers of disease activity, and the QoL of RA patients. This study was carried out in the Rizgary Teaching Hospital in the Kurdistan region of Iraq between December 01, 2021, and March 31, 2022. All female patients with a confirmed diagnosis of RA and aged ≥18 years were included. Data relating to the disease activity score (DAS-28), biochemical measurements of the profile, and hematological indices and ratios were assessed. The QoL of each patient was assessed using the Quality of Life-Rheumatoid Arthritis II (QoL-RA II) and the World Health Organization-Quality of Life (WHOQOL-BREF) scales. A total of 81 participants were included, with a median disease duration of 9 years. The median values of the hematological indices were as follows: mean corpuscular volume, 80 fL; platelet count 282 × 103/mm3; mean platelet volume, 9.7 fL; neutrophil-to-lymphocyte ratio, 2.76; and platelet-to-lymphocyte ratio, 170.5. In six of the eight domains of the QoL-RA II scale, the median score was ≤5, indicating poor QoL. The transformed scores of WHOQOL-BREF domains were <50. Multivariate regression analysis showed significant inverse correlations between plateletcrit and the health domains. The area under the curve of the physical, psychological, and environmental domains was <0.5 at a cutoff value of plateletcrit of 0.25. In RA patients, hematological indices and ratios could serve as a QoL assessment tool, particularly plateletcrit, as higher plateletcrit (≥0.25) were found to negatively impact the physical health, psychological, and environmental domains.