Significant Difference In Platelet Count Research Articles

Association between ascites and primary hyperfibrinolysis: A cohort study in 210 dogs

Coagulation profiles were determined in 70 dogs with ascites, 70 healthy control dogs and 70 sick control dogs without ascites. Dogs with ascites were divided into four sub-groups based on the pathophysiology of fluid formation. Coagulation profile, serum C-reactive protein and frequency of discordant plasma fibrin–fibrinogen degradation products and D-dimer assay results, suggesting primary hyperfibrinolysis, were compared between groups. Within the ascites group, 10 samples of ascitic fluid were transudates due to decreased osmotic pressure, 18 were transudates due to increased hydrostatic pressure, 13 were exudates and 29 were haemorrhagic. Plasma fibrinogen concentrations were significantly lower in dogs with ascites compared to sick dogs without ascites. Activated partial thromboplastin time, prothrombin time, plasma concentrations of fibrin–fibrinogen degradation products and D-dimers, and frequency of primary hyperfibrinolysis, were significantly higher for dogs with ascites compared to both control groups. There was no significant difference in platelet count between groups. The frequency of primary hyperfibrinolysis was highest in dogs with transudative ascites due to increased hydrostatic pressure. Serum C-reactive protein was significantly higher in dogs with ascites compared to both control groups, and significantly and positively correlated with plasma D-dimers. In conclusion, dogs with ascites have an increased frequency of primary hyperfibrinolysis, especially with ascites secondary to increased hydrostatic pressure. The increased inflammation present in these dogs may have activated haemostasis in some cases, explaining the higher plasma D-dimers.

Platelets Cellular and Functional Characteristics in Patients with Atrial Fibrillation: A Comprehensive Meta-Analysis and Systematic Review.

BackgroundThis systematic review with meta-analysis aimed to determine the strength of evidence for evaluating the association of platelet cellular and functional characteristics including platelet count (PC), MPV, platelet distribution width (PDW), platelet factor 4, beta thromboglobulin (BTG), and p-selectin with the occurrence of atrial fibrillation (AF) and consequent stroke.Material/MethodsWe conducted a meta-analysis of observational studies evaluating platelet characteristics in patients with paroxysmal, persistent and permanent atrial fibrillations. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity.ResultsLiterature search of all major databases retrieved 1,676 studies. After screening, a total of 73 studies were identified. Pooled analysis showed significant differences in PC (weighted mean difference (WMD)=−26.93 and p<0.001), MPV (WMD=0.61 and p<0.001), PDW (WMD=−0.22 and p=0.002), BTG (WMD=24.69 and p<0.001), PF4 (WMD=4.59 and p<0.001), and p-selectin (WMD=4.90 and p<0.001).ConclusionsPlatelets play a critical and precipitating role in the occurrence of AF. Whereas distribution width of platelets as well as factors of platelet activity was significantly greater in AF patients compared to SR patients, platelet count was significantly lower in AF patients.

Abstract 145: Development of Novel S100A9 Peptide Vaccine for Prevention of Thrombus Formation in Ischemic Stroke in Mice

Background and purpose: Nonadherence of antithrombotic medicine is one of major risk factors for recurrent strokes. Immunotherapy, such as antithrombotic vaccination, is expected to solve such a problem due to its long-lasting effects. Here, we focused on platelet-derived S100A9, which has directly regulate thrombosis without influence on hemostasis, and examined the antithrombotic effects of newly developed S100A9 vaccine in mice. Methods: S100A9 vaccine was designed to select the short peptide as an antigen of S100A9 conjugated to keyhole limpet hemocyanin (KLH). Male C57BL/6J mice were immunized with S100A9 vaccine three times at 2 weeks interval. Middle cerebral arteries (MCA) was exposed to topical application of 20% ferric chloride. The time to occlude the MCA was examined measuring cerebral blood flow with a laser doppler flowmeter. Bleeding time was assessed by cutting the tail arteries. The thrombus formation was also assessed using the laminar flow chamber. The influences of vaccine for T-cell activation were assed using an IgG subclass ELISA and an enzyme-linked immunosorbent spot (ELISPOT) assay. Results: S100A9 vaccine successfully produced antibodies specific for S100A9 in serum in a dose-dependent manner. After the third immunization, the time to thrombus formation in MCA was significantly prolonged in the mice vaccinated with S100A9 compared to the non-immunized mice (23.3 ± 4.3 min vs 6.9 ± 0.8 min, p&lt;0.01), but bleeding time was same in both groups. There was no significant difference in platelet count in both groups. The formation of platelet thrombus under ex vivo was significantly reduced in S100A9 vaccine group compared to control group (14.8 ± 0.7 x10 4 /μm 2 vs 17.8 ± 0.9 x10 4 /μm 2 , p&lt;0.05). In the IgG subclass ELISA, the IgG1:IgG2b ratio was greater than 1.0 in the S100A9 vaccine group. In the ELISPOT assay using splenocytes isolated from S100A9 immunized mice, stimulation with S100A9 partial peptide did not induce the production of IFN-gamma and IL-4 in comparison with KLH. Conclusion: The S100A9 vaccine could successfully prevent thrombus formation in MCA without influence on hemostasis nor eliciting an autoimmune response. S100A9 vaccine might shed light on the development of safe antithrombotic vaccine in ischemic stroke.

Does obesity cause chronic inflammation? The association between complete blood parameters with body mass index and fasting glucose.

Objective:This study aimed to determine the relationship of complete blood count (CBC) parameters and derivates with fasting blood sugar and the body mass index.Methods:This was a prospective, observational clinical study. Hospitalized patients who received a physiotherapy program in the Physical Medicine and Rehabilitation Clinic between March and June 2016 were included. The age, height, weight, body mass index (BMI), fasting blood glucose, erythrocyte sedimentation (ESR), C-reactive protein, and CBC parameters (leukocytes, platelets, neutrophil, lymphocytes, and monocytes) and red cell distribution width, platelet distribution width, neutrophil–lymphocyte ratio (NLR), and platelet–lymphocyte ratio of the patients were recorded. The relationship between the BMI, fasting glucose, and CBC parameters and derivates were investigated. Patients were divided into groups based on BMI: BMI≤25 kg/m2, normal; BMI=26–30 kg/m2, overweight; and BMI>30 kg/m2, obese. A P value>0.005 was considered statistically significant.Results:A significant difference in the lymphocyte count, ESR, and NLR values was observed among the three groups (P=0.011; P=0.021; P=0.04). A significant difference in NLR was found between groups 1 and 3 (P=0.04). Between groups 1 and 3, a significant difference in platelet count was noted (P=0.013). On dividing the patients into two groups: normal and overweight/obese, a significant difference in lymphocyte count, glucose, and ESR values was observed (P=0.038; P=0.05; P=0.013). The lymphocyte count, ESR, and glucose values were found to be higher in the overweight group. According to Spearman’s correlation analysis, the BMI and NLR values were found to be negatively correlated (P=0.029; r=.145); however, the lymphocyte count and ESR values were positively correlated (P=0.009; r=.173); (P=0.013; r=.182).Conclusion:This study found a negative correlation between the NLR and BMI values and a lower NLR value in the obese group compared with the normal group. The overweight group showed a higher lymphocyte count, thereby confirming the positive correlation of lymphocyte count with BMI. A comprehensive clarification of the mechanisms underlying the relationship between obesity and inflammation may allow developing treatment strategies to reduce the negative effects of obesity.

P3.03-044 Is Toxicity Increased by Adding Intraoperative Chemotherapy to Preoperative Induction Chemotherapy for Mesothelioma Patients?: Topic: Mesothelioma Clinical

Intracavitary application of chemotherapy after mesothelioma resection is intended to prevent local recurrence. In the present study, we compared hematological and renal toxicity of patients treated with or without additional intracavitary cisplatin-fibrin after (extended) pleurectomy/decortication ((e)P/D) and previous i.v. induction chemotherapy with cisplatin/pemetrexed (CTX). Hemoglobin values, platelet count as well as urea, creatinine, sodium, potassium and magnesium values of 32 patients treated with (e)P/D were compared to the first five patients receiving 44mg/m2 BSA intracavitary cisplatin-fibrin in our INFLuenCe-Meso phase II trial (www.clinicaltrial.gov NCT01644994). The median time between last cycle of CTX and surgery was 6 weeks (1-14 weeks). The blood values were measured on postoperative day (POD) 1 to 5, 7, 10 and 14 if available. For statistical comparison Mann-Whitney U test was used. No significant difference between the 2 groups was observed in the preoperative baseline blood samples. On POD3 hemoglobin dropped significantly more in patients with cisplatin-fibrin application (Figure 1A). However, the use of blood transfusion was not significantly different in both groups. Also sodium, potassium (Figure 1B) and magnesium levels were significantly lower in the study patient group. Disorders in electrolytes were however never reflected in clinical symptoms and reached only in 3 patients a CTCAE level ≥3. There was no significant difference in platelet count, urea and creatinine levels. The present analysis shows that additional intracavitary cisplatin-fibrin after eP/D and previous i.v. induction chemotherapy with cisplatin/pemetrexed can lead to electrolyte disorders and drop in hemoglobin concentration. However, none of the mentioned laboratory findings had a clinically significant impact on the patients’ postoperative course.

Insufficient fibrinogen response following free flap surgery is associated with bleeding complications.

Background: Microvascular tissue transfer has become a safe and reliable tool in the reconstructive armamentarium, yielding high success rates. However, little is known about the changes in coagulation after free tissue transfer and their potential impact on morbidity.Methods: Fibrinogen concentration and platelet count among other values were available and assessed in 139 undergoing free tissue transfer before, immediately after, and 1–3 as well as 8–11 days after surgery. In patients undergoing urgent revision for either bleeding or microvascular thrombosis, blood samples were drawn directly before re-exploration. Results: In the patients without any surgical revision and in those with thrombosis of the microvascular pedicle, both fibrinogen concentration and platelet count increased significantly during the early and late post-operative window. Patients that developed bleeding necessitating re-exploration showed an inadequate increase in fibrinogen levels, resulting in significantly lower concentrations compared to the other two groups. There were no significant differences in platelet count or PTT between these groups.Conclusion: Free flap surgery induces acute and subacute changes in coagulation, comparable to other major surgeries and severe injuries. This leads to an increase in platelet count and fibrinogen over the post-operative course. Patients that developed bleeding requiring surgical re-exploration showed an insufficient increase in fibrinogen, resulting in significantly lower fibrinogen levels. Therefore, monitoring and correction of fibrinogen levels might aid in preventing or treating bleeding complications following free flap surgery.

Intraventricular Hemorrhage and Platelet Indices in Extremely Premature Neonates.

Intraventricular hemorrhage (IVH) is a multifactorial disorder, the most important risk factors of which are prematurity and low birth weight. Disturbances in cerebral blood flow, inherent fragility of the germinal matrix vasculature, and platelet/coagulation disturbances are the 3 major pathogenic mechanisms. In this context, we investigated the role of platelet indices and several maternal and neonatal characteristics in the development of IVH through a retrospective cohort analysis of 130 extremely premature neonates, 24% of whom presented with severe IVH. There was a significant difference in platelet counts between the IVH and the control group on the first day of life (P=0.046). Presence of IVH was linked with lower birth weight (P=0.006) and lower gestational age (P=0.001). Platelet count on the first day of life was positively correlated with survival (P=0.001) and, along with platelet mass, was indicative of the worst IVH grade recorded for each neonate (P=0.002 and 0.007, respectively). Prolonged prothrombin time was also correlated with IVH (P<0.001), but factor analysis supported no prominent role. Maternal medications seem to play a minor role as well. In conclusion, IVH in extremely premature infants cannot be solely explained by platelet parameters, and further studies are required to determine the relationships between IVH, platelet indices, and outcomes.

Does centrifugation matter? Centrifugal force and spinning time alter the plasma metabolome.

BackgroundCentrifugation is an indispensable procedure for plasma sample preparation, but applied conditions can vary between labs.AimDetermine whether routinely used plasma centrifugation protocols (1500×g 10 min; 3000×g 5 min) influence non-targeted metabolomic analyses.MethodsNuclear magnetic resonance spectroscopy (NMR) and High Resolution Mass Spectrometry (HRMS) data were evaluated with sparse partial least squares discriminant analyses and compared with cell count measurements.ResultsBesides significant differences in platelet count, we identified substantial alterations in NMR and HRMS data related to the different centrifugation protocols.ConclusionAlready minor differences in plasma centrifugation can significantly influence metabolomic patterns and potentially bias metabolomics studies.Electronic supplementary materialThe online version of this article (doi:10.1007/s11306-016-1109-3) contains supplementary material, which is available to authorized users.

Thrombocytopenia after sutureless aortic valve implantation: Comparison between Intuity and Perceval bioprostheses

Thrombocytopenia after sutureless aortic valve implantation: Comparison between Intuity and Perceval bioprostheses

Cryopreservation protocol for equine platelet-rich plasma

In this preliminary study, a new equine platelet-rich plasma (PRP) cryopreservation protocol was evaluated. PRP was obtained by a double centrifugation technique of whole blood collected from 8 adult healthy ponies. A fresh sample of PRP was analyzed for total platelet count, mean platelet volume (MPV), and platelet morphology. Upon morphological evaluation, 200 platelets were counted using a differential interference contrast microscope with a 40x phase objective and classified as activated (with pseudopodia), inactivated (normal discoid shape), or uncertain state (spherical shape, without pseudopodia). Two other PRP samples, one containing DMSO as a cryoprotectant and the other without DMSO, were stored in a mechanical freezer at –80ºC. After 14 days, the frozen samples were thawed and submitted to the same analysis as described above. The fresh PRP showed a platelet count of 830 (±95.3) x103 uL-1, an MPV of 5.2 (±0.07) fL, and composed of 4% activated platelets. There was no significant difference in platelet count, MPV, and activated platelets between fresh and 6% DMSO frozen PRP samples (617.9±65.5x103uL-1; 5.3±0.06fL; 9.5%) (p &amp;gt; 0.05). On the other hand, samples frozen without DMSO showed a significantly lower platelet count (519.6±66.1x103uL-1), higher MPV (5.7±0.08fL), and more activated platelets (13.9%) than the other groups (p &amp;lt; 0.05). The 6% DMSO was able to preserve platelet morphology in PRP stored at –80oC for 14 days, but studies on platelet function of thawed PRP are still needed.

Relationship between mean platelet volume, platelet distribution width, plateletcrit and varicocele.

Increases in platelet count and platelet indices such as mean platelet volume (MPV), platelet distribution width (RDW) and plateletcrit (PCT) have been reported in a wide range of pathological settings. The aetiology of varicocele, a vascular disease, is poorly defined. In this study, we aimed to examine the relationship between varicocele, platelet count and a series of platelet indices. A total of 69 patients with varicocele and 56 patients without varicocele were enrolled in the study. Patient sperm parameters, platelet, MPV, PDW and PCT values were analysed. There were semen abnormalities in 37 (53.6%) patients in the varicocele group and 19 (33.9%) patients in nonvaricocele group (P<0.05). There was no significant difference in platelet count or platelet indices (MPV, PDW and PCT) between the patients with and without varicocele (P<0.05). There was no statistically significant difference in platelet count or MPV, PDW and PCT between patients with varicocele and the control subjects.

A novel role for von Willebrand factor in the pathogenesis of experimental cerebral malaria

AbstractPlasmodium falciparum malaria infection is associated with an early marked increase in plasma von Willebrand factor (VWF) levels, together with a pathological accumulation of hyperreactive ultra-large VWF (UL-VWF) multimers. Given the established critical role of platelets in malaria pathogenesis, these increases in plasma VWF raise the intriguing possibility that VWF may play a direct role in modulating malaria pathogenesis. To address this hypothesis, we used an established murine model of experimental cerebral malaria (ECM), in which wild-type (WT) C57BL/6J mice were infected with Plasmodium berghei ANKA. In keeping with findings in children with P falciparum malaria, acute endothelial cell activation was an early and consistent feature in the murine model of cerebral malaria (CM), resulting in significantly increased plasma VWF levels. Despite the fact that murine plasma ADAMTS13 levels were not significantly reduced, pathological UL-VWF multimers were also observed in murine plasma following P berghei infection. To determine whether VWF plays a role in modulating the pathogenesis of CM in vivo, we further investigated P berghei infection in VWF−/− C57BL/6J mice. Clinical ECM progression was delayed, and overall survival was significantly prolonged in VWF−/− mice compared with WT controls. Despite this protection against ECM, no significant differences in platelet counts or blood parasitemia levels were observed between VWF−/− and WT mice. Interestingly, however, the degree of ECM-associated enhanced blood–brain barrier permeability was significantly attenuated in VWF−/− mice compared with WT controls. Given the significant morbidity and mortality associated with CM, these novel data may have direct translational significance.

Mean platelet volume in patients with prolactinoma.

Prolactin is a multifunctional pituitary hormone. The effect of prolactin on platelet activation is not well understood. Prolactinomas are the most common type of pituitary adenomas, and they are medically responsive to dopamine agonists. Mean platelet volume (MPV) is a marker of platelet function and activation. The aim of this study was to evaluate MPV values before and 6 months of cabergoline treatment when normoprolactinemia was achieved. A total of 101 newly diagnosed prolactinoma patients and 102 healthy control subjects were included in the study. Patients with hematological disorders that affect MPV and those on medications were excluded. Prolactin, platelet count and MPV levels were recorded before and 6 months after the initiation of cabergoline treatment (0.5 to 1 mg, two times a week). There was no significant difference in platelet count and MPV before and after 6 months of treatment with cabergoline in patients with prolactinoma compared with the control group (p > 0.05). Our results showed that MPV, a marker of platelet function, was unchanged in patients with prolactinoma.

Attenuation of Thrombosis by Crude Rice (Oryza sativa) Bran Policosanol Extract: Ex Vivo Platelet Aggregation and Serum Levels of Arachidonic Acid Metabolites.

Background. Vascular occlusion or thrombosis was often attributed to uncontrolled platelet activation. Influence of sugarcane policosanol extract on platelet was reported but little was known of rice bran policosanol, particularly its mechanisms of actions on platelet activities. Objective. Antiplatelet mechanisms of rice bran policosanol extract (RBE) were studied using hyperlipidemic Sprague Dawley rats. Ex vivo platelet aggregation, platelet count (PC), bleeding time (BT), and coagulation time were assayed. Serum eicosanoids and other aggregation-related metabolites levels were quantified. Design. Rats were divided into 6 groups for comparisons (vehicle control Tween 20/H2O, high dose policosanol 500 mg/kg, middle dose policosanol 250 mg/kg, low dose policosanol 100 mg/kg, and positive control aspirin 30 mg/kg). Results. Low dose 100 mg/kg of RBE inhibited aggregation by 42.32 ± 4.31% and this was comparable with the effect of 30 mg/kg aspirin, 43.91 ± 5.27%. Results showed that there were no significant differences in PC, BT, and coagulation time among various groups after RBE treatment. Serum thromboxane A2 was attenuated while prostacyclin level increased upon RBE treatment. Conclusions. RBE reduced ex vivo ADP-induced platelet aggregation without giving adverse effects. No changes in full blood count suggested that rice bran policosanol did not disturb biological blood cell production and destruction yet it reduced aggregation through different mechanisms.

Study on the kinetics and influence of feline platelet aggregation and deaggregation.

BackgroundFeline platelets are prone to clumping after blood collection, rendering the determination of accurate platelet counts difficult for clinical laboratories and resulting in a high incidence of pseudothrombocytopenia in feline haematology reports. No information is available about the kinetics of platelet aggregate formation in feline ethylenediaminetetraacetic acid blood and the course of platelet counts over a clinically relevant time period. The aim of the present study was to determine platelet counts in healthy cats over a time period of 24 h after blood collection at 9 time points; to assess potential effects of platelet aggregates, anaesthesia and bleeding conditions on feline platelets and white blood cell counts; and finally, to investigate if glucose concentration is associated with the presence of aggregates. From 30 clinically healthy cats, blood samples were analysed at 9 different time points using two different haematology instruments (using fluorescence and impedance-based flow cytometry) in the counting chamber and by blood smear evaluation.ResultsFourteen of the 30 samples were thrombocytopenic at one to 8 time points after collection as analysed on a fluorescence flow cytometry haematology analyser. At the 24-h timepoint, all thrombocytopenic samples had returned to normal platelet counts. Seventeen of the 30 samples showed platelet aggregates in the counting chamber. Significant differences in platelet counts were associated with the presence and size of aggregates and time since bleeding. No statistically significant differences in counts were found with regard to the quality of blood collection or the use of anaesthesia. Platelet aggregation and, therefore, pseudothrombocytopenia occurred in 57 % of the investigated samples at different time points.ConclusionFor the first time, deaggregation of feline platelet aggregates could be demonstrated as a reversible effect of platelet aggregation. For clinical laboratories or veterinarians, it may be helpful to rerun feline samples with pseudothrombocytopenia to obtain a more reliable platelet count. The quality of blood collection seems not to be causative for platelet aggregation. Blood smear evaluation is absolutely indicated in cases when haematology instruments give PLT counts below the reference interval.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-015-0590-7) contains supplementary material, which is available to authorized users.

Can Platelet Count and Platelet Indices Predict the Risk and the Prognosis of Preeclampsia?

Objective: To compare the hematocrit, platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), PC to MPV ratio in the mild preeclamptic (mPE), severe preeclamptic (sPE) and healthy normotensive pregnant women to evaluate whether these parameters have a predictive and prognostic significance in determining the risk and the severity of preeclampsia (PE). Methods: A retrospective case-control study was designed including the patient population (N = 284) composed of 49 mPE, 70 sPE, 165 healthy normotensive pregnant women for controls. Preceding medical histories of all the cases were insignificant. Results: In comparison of the preeclamptic patients with controls; there was statistically significant difference in PC (p = 0.023; p < 0.05), MPV(p = 0.023; p < 0.05), PC/MPV ratio (p = 0.005; p < 0.01). But there was no difference between sPE and mPE. Cut-off value for MPV was calculated as 9 for the diagnosis of PE (p < 0.01), the odds ratio was 1.999. The cut off value for PC was 190, the odds ratio was 1.932. The cut off value was 19.9 for the PLT/MPV, the odds ratio was 2.42. Conclusion: We suggest that the increasing platelet turnover in PE causes a decrease in the PC, an increase of MPV value and especially a decrease in PC/MPV ratio pointing that these parameters may play an important role in predicting the risk of PE while they have no role on predicting the severity of PE. According to our findings we can suggest that the patients with these cut-off values of PC and platelet indices, should be carefully followed for the development of PE.

Do Leukocyte and Platelet Counts Have Benefit for \Preoperative Evaluation of Endometrial Cancer?

The aim of this study was to investigate the association between preoperative leukocyte and platelet counts and the stage of the disease in patients with endometrial cancer. Data for 100 patients undergoing total abdominal hysterectomy and bilateral salpingoophorectomy for benign uterine diseases and 177 patients surgically staged for endometrial cancer at Ondokuz Mayis University, Department of Gynecology and Obstetrics between 2005 and 2013, with preoperative complete blood count in the week prior to surgery including WBC, platelet count, pathologic evaluation for both benign and malign endometrium lesions, tumor stage and presence of lymphovascular space invasion (LVI), were retrospectively analyzed. The preoperative leukocyte count was significantly higher in patients with endometrial cancer when compared to the patients with benign diseases. However, there were no significant differences in platelet counts between the groups. Patients with advanced stage endometrial cancer had higher preoperative leukocyte counts when compared to the early stage disease whereas there was no difference in platelet count. Multivariate regression analysis identified preoperative leukocytosis as an independent prognostic factor for endometrial cancer. The optimal cut-off point for WBC was calculated as 10,500 to differentiate stage 1-2-3 and 4 with 88.9% sensitivity and 86.3% specificity (AUC: 0.901, 95% CI: 0.829-0.973, p<0.001, PPV: 25.8%, NPV: 99.3%). Preoperative leukocytosis is independently associated with advanced endometrial cancer.

1C.09

Objective: Hypertensive patients with CKD present an increased risk for cardiovascular mortality. Among the proteins synthesized and released from adipose tissue, resistin is a cytokine whose physiologic role has been the subject of much research and controversy. We and others have demonstrated that serum resistin levels are higher in patients with CKD and correlate directly with inflammatory markers, including TNF-α and hsCRP. Since inflammation has been consistently linked to atherosclerosis, death, and cardiovascular (CV) events, our goal was to investigate the interaction between resistin levels and long term all-cause and CV mortality in elderly non-obese and non-diabetic with hypertension. Design and method: We studied 80 patients (52 men/28 women) 70.9 ± 8.6 years of age with hypertension and CKD. Exclusion criteria was obesity and diabetes mellitus, active infection, acute illness, chronic inflammatory disease or cancer, and immunosuppresive, anti-inflammatory or anti-lipidemic drugs. Demographic data, clinical information and blood samples were collected prospectively. The patients were observed for 5 years. Results: During the follow-up 28 of 80 (35%) patients died: 16 (57%) deaths due to CV events and 12 (43%) of other causes. Patients who died were older and had higher DBP, compared to survivors, but had no differences in BMI, smoking, SBP and HR. Deceased patients had higher WBC, hsCRP, BUN, creatinine, cystatin C, phosphate, magnesium and potassium levels and lower eGFR, Hct/Hg, T3, T4, total cholesterol, LDL-C, albumin and sodium levels compared to survivors. No significant differences in platelet count, TNF-α, fibrinogen, oxLDL, ADMA, HgA1C and HOMA-index were revealed between the groups. eceased patients had significantly higher resistin levels than survivors at baseline (p = 0.025), but adiponectin, visfatin and leptin did not differ between the two groups. Five variables, namely resistin, sodium, cholesterol, T3 and WBC remained significantly associated with survival and were used in the multivariate Cox regression analysis, which revealed that only resisitin, cholesterol and WBC maintained their discriminatory ability, as independent predictors of mortality both by forward and backward stepwise analysis. Conclusions: Elevated serum resistin was a significant independent biomarker of CV and all-cause mortality in elderly, non-diabetic CKD patients with hypertension.

Platelet parameters and (1, 3)-β-D-glucan as a diagnostic and prognostic marker of invasive fungal disease in preterm infants.

The diagnosis of neonatal invasive fungal disease (IFD) is difficult and often delayed. The platelet parameters and (1, 3)-β-D-Glucan (BG) may be useful for diagnosing IFD, but their diagnostic performance are not well characterized in neonates. We studied 63 preterm infants with IFD, 160 preterm infants without sepsis (preterm control), and 41 preterm infants with bacterial sepsis. Platelet parameters at the first day of onset of IFD and at the fourteenth day after antifungal treatment were evaluated. Serum BG was measured. Platelet count (PC), plateletcrit (PCT), and platelet distribution width (PDW) values were significantly lower, and mean platelet volume (MPV) values significantly higher in the IFD versus preterm control infants. PC and PCT values were much lower in infants with IFD versus bacterial sepsis, and there were significant differences in BG value between the two groups. After 14 days of antifungal treatment, significant elevations in PC, PCT, PDW and reductions in MPV levels in IFD group were observed. Receiver operating characteristic (ROC) curves showed that PC and PCT were strong predictors of IFD. The PC and PCT cut-offs for predicting IFD were 119.5 (sensitivity 78%, specificity 95%) and 0.21 (sensitivity 83%, specificity 85%), respectively. There were significant differences in PC and PCT levels between deceased and survived patients. The PC and PCT cut-offs for predicting deceased IFD were 39 (sensitivity 62%, specificity 86%) and 0.04 (sensitivity 50%, specificity 95%), respectively. The sensitivity in diagnosing IFD by a BG cutoff of ≥10pg/ml was 68.3% and specificity was 75.6%. PC and PCT levels in the BG ≥400 pg/ml group were significantly lower compared to the BG<400 pg/ml group. Platelet parameters and BG could be useful biomarkers for the diagnosis and prognosis of neonatal IFD.

Enzyme replacement and substrate reduction therapy for Gaucher disease

Enzyme replacement and substrate reduction therapy for Gaucher disease