PLT Values Research Articles

Effectiveness of laboratory tests in tracking severely COVID-19 infections

AIM: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a virus that causes COVID-19 (Coronavirus Disease 2019), and poses serious difficulties in terms of healthcare systems and global public health. With the large number of publications on COVID-19, clinicians need a synthesis of evidence to provide guidance when dealing with patients with COVID-19. Emerging studies reveal the existence of numerous demographic, clinical, immunological, biochemical and radiographic data that may be useful for clinicians to predict the severity and mortality of COVID-19. The aim is of this study; To determine laboratory parameters that can predict the course and severity of COVID-19 disease in patients with diagnosed solely SARS-CoV 2 PCR test positivity results and independently of the clinic status of selected patients and based on laboratory findings. MATERIALS AND METHODS: This study is a retrospective cross-sectional study conducted at Karacabey State Hospital between January and April 2022. Among the patients who applied to the COVID-19 outpatient clinic, 469 patients (261 females, 208 males) over the age of 18 and positive for SARS-CoV-2 RT-PCR were included in the study. The patients were divided into groups as outpatients, inpatients and patients in need of intensive care (intensive care unit, ICU). Demographic data (age, gender), COVID-19 RT-PCR results, and simultaneous laboratory parameters of the patients were scanned retrospectively. RESULTS: When CRP, urea, ferritin, LEU, NEU, MONO, RBC, HGB, HCT, MCV, NLR, PLR, CRP-NR, and SII index values were taken into consideration, a statistically significant difference was found between the groups. Creatinine, ALT, AST, LDH, troponin I, mass CK-MB, D dimer, LYM, EOS, PLT, ELR, and PNR values were not significantly different between the groups. CONCLUSIONS: Advantages of this study; Comparing the changes in the patient's other laboratory findings based on a single positive PCR test result and finding meaningful rates in terms of serious covid risk. The disadvantage of this study is that it is a study independent of the patient's clinic and disease stage. CRP, urea, ferritin, and indexes such as NLR, PLR, CRP-NR, and SII index values can be used to predict the severity of the disease.

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.

Protective Effect of Royal Jelly on Some Hematologic Parameters Against Sodium Arsenite Toxicity: A Study in Rats

This study examined the effect of royal jelly on some hematological values against sodium arsenite (NaAsO2)-induced toxicity in rats. Royal jelly is a known functional bee product; therefore, its potential to protect against these effects is of great importance. In this study, the effects of royal jelly on hematologic changes were investigated. In the study, 35 healthy Wistar albino male rats weighing 250–300 g and 12–13 weeks old were used. Rats were divided into different groups by gavage daily for 14 days. WBC, LYM, MID, GRA, RBC, HGB, MCHC, MCH, MCV, HCT, PLT, MPV, and PDW values were measured in blood samples. When the measured values were analyzed, the MID, RBC, MCHC, MCH, MCV, and PDV values did not show statistical significance in all experimental groups (P&gt;0.005). However, significant decreases in %LYM, %MID, HCT, and PLT values and increases in WBC, GRA, and %GRA counts were observed in all groups (P &lt; 0.005). This review shows that royal jelly has a potential effect on the hematological and immune systems against toxicity caused by harmful heavy metals such as arsenic. In particular, further research is required to identify the most effective dosage of royal jelly. The results highlight the protective potential of royal jelly against toxicity, which requires further investigation.

Assessment of the differences of hematological variables and their correlation with glycemic control among type 2 diabetes mellitus patients in Iraq: Comparative cross-sectional study

This research aimed to assess the hematological traits of male adults diagnosed with diabetes and investigate the relationship between blood sugar levels with hematological factors among patients. A cross-sectional comparison study was conducted at Fallujah Teaching Hospital from April 1 to July 30, 2023. The research comprised 185 volunteers, including 125 individuals with type 2 diabetes mellitus (65 with well blood sugar levels and 60 with poorly-regulated blood sugar levels) and 60 healthy individuals serving as controls. The evaluation of hematological parameters was conducted using Swelab-Alfa. An independent T-test was used for assessment. The patients exhibited substantially decreased mean absolute lymphocyte count, Hct, MCHC, and PLT values compared to the control group. The diabetic group had significantly higher mean values for total neutrophil count, absolute basophil counts, RDWSD, RDWCV, PDW, PLCR, and MPV than the control group. Patients with poor glycemic control had substantially elevated levels of Mon, Eos, Bas, MCHC, PLT, MPV, PLCR, and PCT. In contrast, individuals with poor glycemic control had substantially lower levels of Neu, RBC count, and PDW. The findings demonstrated a statistically significant positive connection between neutrophil count, MCV, MCH, MCHC, PDW, MPV, PLCR, and PCT with FBG. Lym, RBC count, and Hct exhibited a statistically significant inverse connection with FBG in individuals with type 2 diabetes mellitus (T2DM). This research demonstrated a notable impact of diabetes mellitus, poor glycemic control, and fasting blood glucose levels on some hematological markers.

Effect of a Dietary Essential Oil Blend in Dairy Cows during the Dry and Transition Period on Blood and Metabolic Parameters of Dams and Their Calves.

Cows face severe challenges of immunosuppression and negative energy balance during transition periods. The current study was designed to investigate the effects of essential oil blend supplementation in dairy cow's ration during dry periods on the health of the cow and calf. In the current study, 45 dry Holstein dairy cows were divided into three groups, each consisting of 15 animals. The control group was without any supplementation; the positive control group was only injected with 0.2 mg/kg levamisole (intramuscular) at 2 months before parturition and 1 month before parturition; and the treatment group was supplemented with 3 g/day for each cow essential oil blend mixed in total mixed ration (TMR). A mixed vaccine against E. coli, Rotavirus, and Coronavirus was administered to all cows before 42 days and after 21 days of calving. The day of the calving of the animal was accepted as day 0. Blood samples were collected from the coccygeal vein of all cows at -60, -45, -30, -15, -7, 0, 1 and 2 days, and the colostrum samples were taken on days 0, 1, and 2. Blood samples were also collected from the jugular vein (V. Jugularis) of the newborn calves on days 0, 1, and 2. The results of the hematological parameters revealed no difference in the total red blood cell count, hemoglobin amount, hematocrit, MCV, MCH, MCHC, RDW, PLT, MPV, and PCT values in both prenatal and postnatal blood of the cows (p > 0.05). In terms of immunological parameters, the total IgG level was significantly higher in the experimental group on the 7th day before birth compared to the other two groups, while the total leukocyte count, lymphocyte count, monocyte count and granulocyte counts were found to be lower after birth (p < 0005). Blood NEFA and BHBA levels were also lower in the experimental group compared to the other two groups (p < 0.005), and the blood glucose level was not different (p > 0.05). In calves, no difference was found between the groups in any of the parameters examined (p > 0.05). It is concluded that the dietary addition of an essential oil blend during the transition period enhanced the immune status and energy metabolism of cows without any effect on the health status of newborn calves.

Is Periodontal Disease a Risk Factor for Premature Birth and Low Birth Weight

Aim: Premature birth or low birth weight has an important place in neonatal mortality and morbidity. Today, there are still cases whose etiology has not been fully elucidated. The aim of this study is to evaluate the effect of periodontal diseases on adverse pregnancy outcomes by using the current classification system accepted at the 2017 World Workshop. Materials and Methods: This study was carried out on 172 women who were followed up and delivered in the department of obstetrics and gynecology of our university’s medical faculty hospital. Demographic characteristics of all individuals were recorded and laboratory values were examined. While those with a gestational age &lt;37 weeks and/or baby birth weight &lt; 2500 g were constituted to the case group (n=85), those with a gestational age ≥ 37 weeks and/or baby birth weight ≥ 2500 g constituted the control group (n=87). Clinical periodontal and radiographic evaluations including plaque index (PI), gingival index (GI), bleeding on probing (BOP %), probing pocket depth (PPD) and clinical attachment level (CAL) values were performed for all individuals, and the diagnoses were made by the applied classification system. Analyzes were performed between the two groups to examine the relationship between periodontal disease and adverse pregnancy. Results: PI, GI, BOP %, and PPD values in the case group were significantly higher compared to the control group (p&lt;0.001). Although the CAL value was higher in the case group, the difference was not significant (p=0.058). WBC (p=0.020) and PLT (p&lt;0.001) values were significantly higher in the case group. Conclusion: According to the results of this study, periodontal diseases are associated with adverse pregnancy outcomes independent of other risk factors. Women should pay attention to their oral hygiene and dental examinations before and during pregnancy.

Do Hematologic Parameters Predict Thrombosis or Disease Transformation in Essential Thrombocythemia?

Background: Patients with essential thrombocythemia (ET) are burdened with an increased risk of thrombosis and disease transformation, both significant contributors to morbidity and mortality. However, based on the available literature, there are limited tools available to predict the development of these complications. Particularly, the association between hematologic parameters and thrombosis is unclear, making risk stratification and disease management challenging. Utilizing a large retrospective database, we assessed the impact of hematocrit (Hct), red blood cell count (RBC), white blood cell count (WBC), and platelet count (Plt) on the subsequent development of thrombosis and disease transformation to myelofibrosis (MF), polycythemia vera (PV), and acute leukemia. Methods: We included ET patients treated at our institution between 2007 and 2021. The index time was date of diagnosis or date of first contact at Mount Sinai Hospital for patients with a prior history of ET. Hematologic parameters (Hct, RBC, WBC, Plt) were documented at three-month intervals after the index time. Patients were included in the study if they had at least three sets of laboratory values prior to the outcome of interest. For each hematologic parameter, we performed univariate cox analysis of time to thrombosis or progression to either MF, PV, or acute leukemia. Each lab parameter was analyzed as a time dependent covariate, taking into account the length of time the patient was above or below the threshold of interest. Hct and plt were specifically evaluated as dichotomous variables, with a cut off of less than or greater than 45% for Hct based on CYTO-PV results. For plt, two cut-off values were used: less than or greater than 400 (based on ELN response criteria) and less than or greater than 600 (based on Cortelazzo et al HU treatment goal) in plt/microliter. Results: We identified 430 patients who met criteria and were included in the analysis. Our cohort of patients was mostly female (61%), non-Hispanic (66%), white (64%), JAK2 mutated (60%), with an average age at diagnosis of 56 years and a median follow-up time of 33 months. 41 (7%) patients had a history of prior thrombosis. There was a total of 23 major thromboses that occurred after the index time with 12 venous and 11 arterial thrombotic events. 38 patients progressed to post ET-MF, 20 patients developed post ET-PV, and 10 patients transformed to acute leukemia. For the assessment of thrombotic risk, there were no significant associations between any of the hematologic parameters and this outcome. We also evaluated the risk of thrombosis in the JAK2 positive subset of patients (n of 15), and did not find any significant association with any of the lab parameters (in particular, for hct &amp;lt; 45%, p &amp;gt; 0.99). For transformation to MF, plt &amp;lt; 400 x10 9/L was associated with an increased risk of the development of post-ET MF (HR 2.2, p 0.016), and the same was seen with plt &amp;lt; 600 x10 9/L (HR 2.2, p 0.044). The development of PV was less likely with a hct lower than 45% (HR 0.03, p &amp;lt; 0.001), with similar results seen for plt &amp;lt; 400 x10 9/L (HR 0.2, p 0.03) and plt &amp;lt; 600 x10 9/L (HR 0.2, p 0.002). For transformation to acute leukemia, plt &amp;lt; 400 x10 9/L (HR 8.3, p 0.008) was associated with an increased risk of this complication. Conclusions: In this retrospective cohort of 430 patients with ET, we found no associations between four different hematologic parameters over time with thromboses. In particular, this data once again argues against aiming to achieve a particular platelet goal to minimize thrombosis in ET patients. The lack of association between hematologic parameters and thrombotic risk was similarly exemplified in our subset of JAK2 mutated ET patients. Pertaining to disease transformation, plt count appeared to be the most predictive out of all of the parameters, with lower plt values corresponding to increased risk of both post-ET MF and acute leukemia, which both warrant further exploration. A hct level of less than 45% appeared to be protective against the development of post-ET PV. Significant limitations of our study include the retrospective nature as well as the small number of events of interest that our patients experienced. Future studies must continue to focus on surrogate endpoint validation in order to more reliably predict thrombotic events as well as disease progression in patients with ET given the significant morbidity and mortality that such events incur.

The effect of white blood cell and platelet values on mortality in patients with abdominal aortic aneurysm

Objective: In this study, we aimed to investigate the relationship between preoperative inflammatory markers, length of hospital stay, and mortality in patients with abdominal aortic aneurysm (AAA) who underwent surgical repair.&#x0D; Methods: A total of 83 patients diagnosed with AAA were included in the study. A complete blood count (CBC) was performed on the first visit (pre-op 0-1 hour) in all patients. Non-ruptured cases (AAA) and ruptured cases (AAA-R) were compared.&#x0D; Results: 14.5% (n=12) of the patients died. Higher White blood cells and neutrophils were obtained in patients who died than in surviving patients (respectively, p=0.0002, p=0.001). Higher WBC and NALP in AAA-R patients were determined.&#x0D; Conclusion: WBC and Neu's values were higher in AAA patients who died post-operatively and who were detected rupture pre-operatively but PLT and HB values were similar. Normal or near-normal HB and PLT values that will be seen in the first examination of AAA cases in the emergency department may mislead clinicians or cause them to display a more optimistic attitude.

Super Formula for Diagnosing Disseminated Intravascular Coagulation Using Soluble C-Type Lectin-like Receptor 2.

The diagnostic usefulness of sCLEC-2 and several formulas, including sCLEC-2xD-dimer, sCLEC-2/platelet count (sCLEC-2/PLT), and sCLEC-2/PLT × D-dimer (sCLEC-2xD-dimer/PLT), were evaluated among 38 patients with DIC, 39 patients with pre-DIC and 222 patients without DIC or pre-DIC (non-DIC). Although the plasma level of sCLEC-2 alone was not a strong biomarker for the diagnosis of DIC or pre-DIC, the sCLEC-2xD-dimer/PLT values in patients with DIC were significantly higher than those in patients without DIC, and in a receiver operating characteristic (ROC) analysis for the diagnosis of DIC, sCLEC-2xD-dimer/PLT showed the highest AUC, sensitivity, and odds ratio. This formula is useful for the diagnosis of both pre-DIC and DIC. sCLEC-2xD-dimer/PLT values were significantly higher in non-survivors than in survivors. The sCLEC-2xD-dimer/PLT formula is simple, easy, and highly useful for the diagnosis of DIC and pre-DIC without the use of a scoring system.

Kadmiyuma (CD) maruz kalan dişi sıçanlarda Lactobacillus plantarum (LP) uygulamasının bazı kan parametreleri ve ANAE-pozitif lenfosit oranları üzerine kısmi koruyucu etkileri

We aimed to research the influences of oral L.plantarum administration on some blood parameters and alpha-naphthyl acetate esterase (ANAE)-positive lymphocyte ratios in female rats exposed chronically to Cd. In order to perform this investigation, rats were separated into four equal groups as control (C, n = 8), cadmium (Cd, n = 8), L.plantarum (n = 8), and Cd+ L.plantarum (n = 8). Cd (2.04 mg / mL) was orally applicated to Cd and Cd+ L.plantarum groups for 28 days. In addition, active-live L.plantarum (approximately 108 - 109 cfu / mL) was applicated orally to L.plantarum and Cd+ L.plantarum groups at the same time. C group animals received only fresh water and standard rat food during the study. After the applications, animals were decapitated and blood samples were collected for evaluating of some blood parameters (WBC and its different sub-types, RBC, HCT, MCV, MCH, MCHC, and PLT) and also ANAE-positive lymphocyte ratios. WBC counts were determined the highest in the Cd group compared to other experimental groups (p &lt; 0.05). On the other hand, LP administration caused a significant amelioration in WBC counts of Cd+ L.plantarum group animals when compared to Cd group (p &lt; 0.05). Although NEU counts were detected the highest in the Cd group, these counts decreased due to oral L.plantarum administration in Cd+ L.plantarum group (p &lt; 0.05). Increased PLT values due to CD administration were fixed by using LP diet in the Cd+ L.plantarum group compared to the Cd group in the study (p &lt; 0.05). In conclusion, L.plantarum partially affects female rats’ blood parameters from the harmful effects of Cd.

Does complete blood count have a role in the prediction of deep vein thrombosis?

It was planned as a retrospective case-control study in which 1,527 patients between January 2022 and September 2022 were evaluated. After the eligibility criteria, systematic sampling was performed and analyzed in the case group (103) and the control group (179) patients. The predictive significance of Hb, NLR, PLR, MPV, PLT, MPV/PLT, monocytes, lymphocytes, eosinophils, RDW, LMR, and PDW parameters for the development of DVT was investigated. Then, logistic regression analysis was performed with these parameters to analyze the predictive value. The cutoff point was determined by performing ROC analysis for the statistically significant parameters. Neutrophil, RDW, PDW, NLR, and MPV/platelet values were statistically higher in the DVT group than the control group. Lymphocyte, PLT, and LMR values were statistically lower in the DVT group than the control group. There was no statistical difference between the two groups in terms of neutrophils, monocytes, eosinophils, Hb, MPV, and PLR values. RDW and PDW values were statistically significant for DVT prediction (p < 0.001, OR = 1.183 and p < 0.001, OR = 1.304, respectively). According to ROC analysis, 45.5fL for RDW and 14.3fL for PDW were determined as the cutoff points for DVT prediction. We found RDW and PDW to be significant in terms of DVT prediction in our study. We found the NLR and MPV/PLT to be higher in the DVT group, and the LMR to be lower in the DVT group, but we found that there was no statistically significant predictive value. CBC can be used as an inexpensive and easily accessible test that has predictive significance for DVT. In addition, these findings need to be supported by prospective studies in the future.

Prediction of Perforated and Nonperforated Acute Appendicitis Using Machine Learning-Based Explainable Artificial Intelligence

The primary aim of this study was to create a machine learning (ML) model that can predict perforated and nonperforated acute appendicitis (AAp) with high accuracy and to demonstrate the clinical interpretability of the model with explainable artificial intelligence (XAI). A total of 1797 patients who underwent appendectomy with a preliminary diagnosis of AAp between May 2009 and March 2022 were included in the study. Considering the histopathological examination, the patients were divided into two groups as AAp (n = 1465) and non-AAp (NA; n = 332); the non-AAp group is also referred to as negative appendectomy. Subsequently, patients confirmed to have AAp were divided into two subgroups: nonperforated (n = 1161) and perforated AAp (n = 304). The missing values in the data set were assigned using the Random Forest method. The Boruta variable selection method was used to identify the most important variables associated with AAp and perforated AAp. The class imbalance problem in the data set was resolved by the SMOTE method. The CatBoost model was used to classify AAp and non-AAp patients and perforated and nonperforated AAp patients. The performance of the model in the holdout test set was evaluated with accuracy, F1- score, sensitivity, specificity, and area under the receiver operator curve (AUC). The SHAP method, which is one of the XAI methods, was used to interpret the model results. The CatBoost model could distinguish AAp patients from non-AAp individuals with an accuracy of 88.2% (85.6-90.8%), while distinguishing perforated AAp patients from nonperforated AAp individuals with an accuracy of 92% (89.6-94.5%). According to the results of the SHAP method applied to the CatBoost model, it was observed that high total bilirubin, WBC, Netrophil, WLR, NLR, CRP, and WNR values, and low PNR, PDW, and MCV values increased the prediction of AAp biochemically. On the other hand, high CRP, Age, Total Bilirubin, PLT, RDW, WBC, MCV, WLR, NLR, and Neutrophil values, and low Lymphocyte, PDW, MPV, and PNR values were observed to increase the prediction of perforated AAp. For the first time in the literature, a new approach combining ML and XAI methods was tried to predict AAp and perforated AAp, and both clinical conditions were predicted with high accuracy. This new approach proved successful in showing how well which demographic and biochemical parameters could explain the current clinical situation in predicting AAp and perforated AAp.

An evaluation of the laboratory and clinical data of the Crimean-Congo hemorrhagic fever patients during the Covid-19 pandemic

In this study, the purpose was to investigate the demographic, laboratory, and clinical characteristics of the Crimean-Congo Hemorrhagic Fever (CCHF) cases that were treated in our hospital during the Coronavirus disease-2019 (COVID-19) pandemic. It was also investigated whether the patients hospitalized with a provisional diagnosis of CCHF who tested negative for CCHF PCR were infected with COVID-19. In our study, data (epidemiological, clinical, laboratory, prognosis) from 38 patients diagnosed with CCHF through reverse-transcriptase polymerase chain reaction (PCR) and viral-RNA and/or Immunoglobulin M antibodies using ELISA between May 2020 and November 2022 were investigated retrospectively. Of all the patients, 23 were CCHF PCR (+) and 15 were CCHF PCR (-).15 (65.2%) of PCR (+) patients and 9 (60%) of PCR (-) patients were engaged in farming. 65.2% of PCR (+) and 26.7% of PCR (-) patients presented with a history of tick bites. 21 (91.3%) of PCR (+) and 12 (80%) of PCR (-) patients had a history of rural living. Among the PCR (+) patients, 65.2%, 17.4%, and 17.4% received treatment for CCHF in 2022, 2021, and 2020 respectively. 87% of PCR (+) and 60% of PCR (-) patients were discharged after full recovery. The most common symptoms were fever, diffuse body ache, weakness, and headache. Significant differences were found between PCR (+) and PCR (-) patients in terms of leukocytes, LDH, INR, NEU, PLT, fibrinogen, and NLR values. 3 patients hospitalized with a provisional diagnosis of CCHF tested negative for CCHF PCR and positive for COVID-19 PCR. Thoracic CT, clinical, and laboratory findings of these patients showed no differences from the other patients. The possibility of misdiagnosis should be considered in CCHF and COVID-19 infections due to their similar symptoms and indications. Extensive multicentric studies need to be conducted to investigate the causes of the increased number of CCHF cases during the pandemic.

The role of IL-6, thiol–disulfide homeostasis, and inflammatory biomarkers in the prediction of acute appendicitis in children: a controlled study

This study aimed to examine the diagnostic value of IL-6, thiol-disulfide homeostasis, complete blood count and inflammatory biomarkers in the prediction of acute appendicitis in children. The study was designed as a prospective and controlled study in children-the study was conducted at a tertiary referential university hospital between May 2020 and April 2021. Patients were divided between study groups and one control group (CG): 1: confirmed acute appendicitis group (AAP); 2: perforated appendicitis group (PAP); and 3: non-specified abdominal pain (NAP). The age and gender of the patients were determined. The following listed laboratory parameters were compared between groups: TOS: total oxidative status, TAS: total antioxidant status, OSI: oxidative stress index, TT: total thiol, NT (µmol/L): native thiol, DIS: disulfide, IL-6: interleukin 6, TNF-a: tumor necrosis factor-alpha, WBC: white blood cell, NEU: neutrophil, NEU%: neutrophil percentage, LY: lymphocyte, LY%: lymphocyte percentage, PLT: platelet, MPV: mean platelet volume NLR: neutrophil lymphocyte ratio, CRP: C-reactive protein, LCR: lymphocyte CRP ratio, and serum lactate. The TOS level of the PAP group was found to be significantly higher than that in the AAP, NAP and control groups (p = 0.006, < 0.001 and p < 0.001). TAS, TT, and NT levels in the PAP group were significantly lower than those in the AAP, NAP and control groups. OSI was significantly higher in the PAP group than in the other groups. The TT and NT levels of the NAP group were both similar to those of the control group. Serum DIS level was similar between the AAP and PAP groups, AAP and NAP groups, and NAP and control groups. Serum IL-6 and TNF-α levels were found to be significantly higher in the PAP group compared to those in all groups. The WBC, NEU, and NEU% values were found to be significantly higher in the PAP group than those in the NAP and control groups, while LY and LY% values were found to be significantly lower. PAP and AAP groups were found to be similar in terms of WBC, NEU, LYM, NEU%, and LYM% values. PLT and MPV values and serum lactate values did not show a significant difference between the groups. NLR was similar in the AAP and PAP groups. A significant increase in CRP versus a decrease in LCR was detected in the PAP group compared to that in the AAP group. Multivariate analysis demonstrated that only IL-6 has significant estimated accuracy rates as 80% for the control group, 78.8% for AAP, 96.9% for PAP, and 81.6% for NAP. Rather than AAP, PAP caused significantly higher oxidative stress (increased TOS and OSI), and lower antioxidation capacity (decreased TT and NT). IL-6 levels can provide a significant stratification. Nevertheless, simply detecting WBC or CRP is not enough to distinguish the specific pathology in acute appendicitis and related conditions.

What are the Alternatives to the LRINEC Score in Identifying Necrotizing Soft Tissue Infections in the Emergency Department?

Background: The emergency department (ED) is an dynamically high-risk setting. Our aim is to determine the blood parameters associated with necrotizing soft tissue infections (NSTI) to strengthen the LRINEC score. &#x0D; Materials and methods: We analyzed 109 patients who were diagnosed with necrotizing soft tissue infection in the Urology, Dermatology, Plastic surgery and General Surgery clinics of Atatürk University between 2013 and 2016. In the same period, we matched 624 patients diagnosed with cellulitis as a control group. &#x0D; Results: Of four defined clinic's records to Atatürk University Hospital in 2013 to 2016, 109 matched and 624 matched control records were abstracted. Diagnoses associated with the NSTIs were: gangrene (n=47), gas gangrene (n=7), Fournier's gangrene (n=44) and necrotizing fasciitis (n=11). In patients with Necrotizing Soft Tissue Infection, BUN (p=0,00), K (0,011), Neutrofil (p=0,013), Lenfosit (p=0,003), Htc (p=0,00), RDW (p=0,002), Plt (p=0,042), AST (p=0,00), ALT (p=0,00) and INR (p=0,003) values were found to be statistically significant in making the diagnosis. &#x0D; Conclusion: BUN, K, Neutrofil, Lenfosit, Htc, RDW, Plt, AST, ALT and INR values measured from blood tests of patients diagnosed with NSTI can be used in distinctive diagnosis of Soft Tissue Infection (STI). Increased awareness of these values may improve Emergency Department (ED) decision making and prevent miss diagnose.

Hemogram Parametrelerinin Antagonist Protokollü IVF-ICSI Siklus Başarısını Öngörmede Etkisi

Objective: In IVF-ICSI cycles with GnRH antagonist protocol, it was aimed to investigate the effects of hCG day hemogram values on OPU and IVF-ICSI success, implantation and clinical pregnancy rates. Methods: Patients who underwent IVF-embryo transfer (ET) cycle after controlled ovarian stimulation (COS) ICSI treatment in a secondary care center between 2019 and 2020 were retrospectively screened. The effects of the differences in Hgb, HCT, Plt, WBC, P-LCR, PDW, RDW-CV, RDW-SD, and MPV values, which are among the hCG day CBC parameters of the cases, on the total oocyte (immature (M1)+mature (M2)+ germinal vesicle (GV)) and M2 oocyte counts obtained after OPU, the number of fertilized oocytes (two pronuclei (2PN)) obtained after IVF-ICSI, implantation and clinical pregnancy rates were evaluated. Results: During the study, 171 patients were evaluated. No significant correlations were found between the Hgb, HCT, WBC, P-LCR, PDW and MPV values of the cases and the number of aspirated follicles, total oocytes and M2 oocytes after OPU (p&amp;gt;0.05). No significant correlations were found between the number of 2PN and freeze embryos obtained after IVF-ICSI, implantation and clinical pregnancy rates (p&amp;gt;0.05). A negative, low or insignificantly strong statistically significant correlation (r=-0.160 and p=0.037) was found between the platelet count and the number of follicles aspirated after OPU. It was observed that there were negative, low or insignificantly strong statistically significant correlations between the RDW-CV values of the cases and the number of 2PN and freeze embryos obtained after IVF-ICSI (r=-0.164, p=0.032 and r=-0.224, p=0.004, respectively). In addition, negative, low or insignificantly strong statistically significant correlations were found between the RDW-SD value and the number of follicles aspirated after OPU, total oocytes, and M2 oocytes (r=-0.247, p=0.001; r=-0.24, p=0.003; r=-0.220, p=0.004 respectively). Negative, low or insignificantly strong statistically significant correlations were found between the RDW-SD value and the number of 2PN, and freeze embryos obtained after IVF-ICSI (r=-0.219, p=0.004; r=-0.229, p=0.003 respectively). Conclusion: In conclusion, no significant correlation could be found between women's hCG day Hgb, Hct, WBC, P-LCR, PDW and MPV values and OPU results or IVF-ICSI success, and these values were not predictive during the treatment process. It was determined that none of the hemogram parameters affected the implantation or clinical pregnancy rates in the treatment cycles. Although we found that OPU results worsened with increasing Plt or RDW-SD values, and fertilization success decreased with increasing RDW-SD and RDW-CV values, the strength of these correlations was weak.

Study of the Significance of Thromboelastography Changes in Patients with Dyslipidemia.

Purpose To investigate the changes in thromboelastography (TEG) in patients with dyslipidemia to study its effect on the blood coagulation status. Methods 131 patients hospitalized in Fujian Provincial Jinshan Hospital from January 2018 to December 2020 were selected, and 64 cases in the hyperlipidemia (HL) group and 67 cases in the non-HL group were set according to whether their blood lipids were abnormal. By measuring the changes of each parameter of TEG in patients, the relevant parameters R value, K value, α angle, and MA value were calculated. And routine blood coagulation (PT, APTT, INR, FIB, and TT) and routine blood (platelet count) tests were performed on all study subjects to analyze the changes of each index of the coagulation function and each parameter of TED in both groups and explore the clinical value of TEG on HL diseases. Results Compared with the non-HL group, R and K values decreased, and angle and MA values increased in the HL group (P < 0.05). PT, APTT, and INR values decreased, and FIB values increased in the HL group compared with the nonhyperlipidemic group (P < 0.05). The TT levels were similar in the non-HL group and the HL group (P > 0.05). Compared with the non-HL group, PLT values decreased, and PDW and MPV values increased in the HL group (P < 0.05). R value was positively correlated with APTT, r= 0.373, P=0.002. K value was negatively correlated with PLT, r= −0.399, P=0.002. α angle and MA values were positively correlated with PLT, r= 0.319/0.475, P=0.010/P < 0.001. The rest of the indexes did not correlate with each parameter of TEG significant correlation. Conclusion TEG can predict the hypercoagulability and hypocoagulability of blood by the changes of R value, K value, α angle, and MA to evaluate the effect of hyperlipidemia on the coagulation status, which is important for guiding the adjustment of lipid-lowering, antithrombotic, and anticoagulation programs in patients with atherosclerosis combined with hyperlipidemia or postsurgery combined with hyperlipidemia.

Verification of a 6-part differential haematology analyser Siemens Advia 2120i.

IntroductionThe aim of this study was to perform a comprehensive verification of a 6-part differential haematology analyser Siemens Advia 2120i (Erlangen, Germany), prior to its routine implementation.Materials and methodsOur verification protocol included: precision (within- and between-run), estimated bias (%) as measure of trueness, which was calculated from observed and manufacturers’ declared value, analytical measuring interval (AMI), carryover, confirmation of a limit of blank (LoB), determination of a limit of detection (LoD) and limit of quantitation (LoQ). The K2 ethylenediaminetetraacetic acid (EDTA) patients’ leftover samples were used for verification of analyser Advia 2021i. Acceptance criteria were based on manufacturer technical specifications (Siemens), 2016 state-of-the-art criteria (Vis and Huisman), and EFLM Biological Variation Database.ResultsThe within- and between-run precision were acceptable for all parameters and the lowest coefficients of variation were observed for mean corpuscular volume (MCV) (0.3% and 0.6%, respectively). Estimated bias was within the acceptance criteria for all parameters except for MCV (the estimated bias was 2.2% (acceptance criteria 2.0%). AMI was confirmed for all tested parameters (r > 0.99). The carryover estimates ranged from 0.1% for platelet count (Plt) to 0.6% for red blood cell count and were within the manufacturers’ specifications (≤ 1%). Manufacturers’ claims for LoB were confirmed for leukocytes, erythrocytes, haemoglobin, and platelets. The estimated LoD and LoQ were 0.05 x109/L and 0.1 x109/L for white blood cell count, while for Plt values were 2 x109/L and 3 x109/L, respectively.ConclusionsAnalytical performance of the Siemens Advia 2120i meets predefined quality goals and is suitable for routine use in a clinical laboratory.

Evaluation of blood transfusion rate in obstetric patients.

The aim of this study was to analyse the obstetric patients who underwent transfusion in the gynecology and obstetrics clinic. Obstetric patients who underwent a blood transfusion in the peripartum period were included in the study. A total of 213 patients who needed blood transfusion were identified. Patients' age, gravida, parity, gestational week, delivery types, blood transfusion indication and time, transfusion rate, blood products used, number of transfusions, peripartum hysterectomy status, neonatal APGAR scores and hemoglobin (Hb), hematocrit (Hct), red blood cell (RBC), platelet (Plt) values which counted before and after transfusion were recorded by scanning patient files from the hospital registry system. The overall blood transfusion rate of the patients who gave birth in our clinic was 2.51%. Uterine atony (50.7%) and chronic anemia (32.9%) were found as the most frequent indications of blood transfusion in the patients included in the study. Antenatal mean Hb of all transfusion patients was 9.8; postpartum mean Hb was 8.2. Pre-transfusion mean Hb, RBC, Hct, Plt values calculated as 7, 3.9, 30.3, 245.2, respectively; post-transfusion mean Hb, RBC, Hct, Plt values were 9, 3.52, 27.5, 215.1, respectively. Due to blood replacement, supply difficulties and transfusion complications, the profit-loss relationship should be individualized and clearly demonstrated before it is applied to the patient. In unpredictable obstetric situations that cause bleeding, staying up to date on current guidelines on pharmacological, hematological and surgical interventions and having an active blood transfusion center in the healthcare provider is very important in reducing maternal mortality and morbidity rates.

The Role of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratios in Predicting H Pylori Positivity And Severity in Patients with Chronic Gastritis

Objective: Chronic gastritis is one of the most common diseases in the World. It is estimated that more than half of the World's population will have chronic gastritis at any time in life. H pylori are the most common cause of chronic gastritis. In the previous studies, WBC, neutrophil, lymphocyte, PLT, and mean platelet volume (MPV) values and their ratios are used as inflammatory indicators. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) is among the most critical indicators. This study aimed to show whether there is a relationship between H pylori positivity and severity and these parameters in patients who underwent Upper Gastrointestinal system endoscopy. Method: The files of 1689 patients who underwent upper gastrointestinal endoscopy were scanned for this study. According to laboratory results and pathology reports, the patients were divided into H pylori positivity and non-H pylori positivity. The hemogram results of the patients in both groups were examined, and neutrophil, lymphocyte, thrombocyte values were recorded. NLR and PLR were calculated. Results: 722 (42.7%) of the patients were male, and 967 (57.3%) were female. While H pylori were positive in 838 (49.6%) patients, 851 (50.4%) patients did not have H pylori positivity. Among H pylori-positive patients, 407 patients (48%) had mild, 280 (33%) moderate H pylori positivity, and 151 patients (19%) had severe H pylori positivity. When the patients were divided into mild, moderate, and severe groups according to H pylori positivity, NLR and PLR were statistically significantly lower as H pylori severity increased. On the other hand, when both groups were compared according to H pylori positivity, no statistically significant difference was found between the two groups in terms of age, albumin, AST, ALT, WBC, Neutrophil, PLT, NLR, PLR values. Conclusions: Our study found that NLR and PLR values were statistically significantly lower as H pylori severity increased. Therefore, when we evaluate our results in light of the literature, we assume that it is more appropriate to use PLR and NLR values together rather than separately as inflammatory markers regarding H pylori severity.