Platelet indices (PI) -- plateletcrit, mean platelet volume (MPV) and platelet distribution width (PDW) -- are a group of derived platelet parameters obtained as a part of the automatic complete ...blood count. Emerging evidence suggests that PIs may have diagnostic and prognostic value in certain diseases. This study aimed to summarize the current scientific knowledge on the potential role of PIs as a diagnostic and prognostic marker in patients having emergency, non-traumatic abdominal surgery. In December 2015, we searched Medline/PubMed, Scopus and Google Scholar to identify all articles on PIs. Overall, considerable evidence suggests that PIs are altered with acute appendicitis. Although the role of PI in the differential diagnosis of acute abdomen remains uncertain, low MPV might be useful in acute appendicitis and acute mesenteric ischemia, with high MPV predicting poor prognosis in acute mesenteric ischemia. The current lack of consistency and technical standards in studies involving PIs should be regarded as a serious limitation to comparing these studies. Further large, multicentre prospective studies concurrently collecting data from different ethnicities and genders are needed before they can be used in routine clinical practice.
Objective: To investigate the importance of the Hemoglobin/Red cell distribution width ratio (Hb/RDW) and Neutrophil/Lymphocyte ratio (NLR) in predicting bladder lamina propria invasion before ...transurethral resection in non-muscular invasive bladder cancer (NMIBC) patients Methods: The data of the patients whose pathology after transurethral resection of the bladder was NMIBC between January 2010 and June 2016 were evaluated retrospectively. Group 1 had Ta (mucosa involvement) and Group 2 had T1 (submucosa involvement) lesions. The age, gender, tumor size and number of tumors of the patients were identified. The preoperative blood leucocyte (WBC), hemoglobin (Hb), neutrophil (N), lymphocyte (L), monocyte (M), platelet (PLT), mean platelet volume (MPV), and red cell distribution width (RDW) values were identified and the NLR, PLR, LMR values calculated. The Hb/RDW ratio was determined. Results: A total of 369 patients were evaluated. The mean age was similar between groups. Group 1 (Ta) consisted of 219 patients (66.3±10.7 years) and Group 2 (T1) 150 patients (66.9±10.4 years) (p=0.638). NLR was higher in Group 2 than Group 1 (2.4 (1.5) and 2.2 (1.5), respectively, p=0.042) and this difference was statistically significant. The Hb/RDW ratio in Group 2 was lower than in Group 1 (0.89±21 and 0.94±19, respectively, p=0.019) and this difference was statistically significant. Conclusion: We believe that a decrease in the Hb/RDW ratio and increase in NLR, which can be easily determined from the peripheral blood in the preoperative period, can be associated with lamina propria invasion (T1). These studies should be supported with prospective large series.
In clinical laboratories, a common practice used to verify tests prior to reporting is repeat testing. Our objective was to evaluate the differences between the results of blood ethanol concentration ...(BEC) test repetitions and report on the role of repeat testing to prevent reporting of incorrect results.
We conducted a retrospective study of data retrieved from the Bursa Yuksek Ihtisas Training and Research Hospital's document management system by calculating the percentage change between repeated BEC test runs. To assess for clinical relevance, the bias between two results from the same sample was compared using the 1988 Clinical Laboratory Improvement Amendments' (CLIA) proficiency testing allowable total error (TEa) limits.
From a total of 1,627 BEC tests performed between January 2017 and January 2018, 70% (1,133) were repeat tested. Of these, 830 resulted in BECs between 0-5 mmol/L, of which 237 (28.5%) were above the 25% acceptable TEa. Two hundred seventy-six BEC test results were greater than >14 mmol/L, and there was a good consensus between the initial and repeat test results (99%). In this group, the mean bias was 0.0% (95%, CI = -9.8-9.8%). However, three of the repeat test results were considered significantly different. There were two discordant results in the 5-14 mmol/L ethanol level, and the mean bias was 2.1% (95%, CI = -15.0-19.1%).
The majority of the repeated BEC test values were the same as the baseline value; therefore, there may be limited benefit in continuing such frequent repeated analyses.
Albumin undergoes structural changes under ischemia and oxidative stress, turning into ischemia-modified albumin (IMA). It has been proposed as an early biomarker for various diseases associated with ...ischemia. We aimed to investigate the relationship between serum IMA and peripheral artery disease (PAD) and whether it is a risk marker for the severity of PAD.
This prospective case-control study included 100 patients with lower extremity PAD and 50 volunteers without. Patients with resting pain, ulcer, and gangrene were excluded from the study. Patients with PAD included in the study were divided into two groups as mild claudication and moderate-severe claudication. Adjusted-IMA levels were calculated according to the median albumin values of the groups. The basic clinical features and laboratory findings of the participants were recorded and compared. Possible risk factors for presence and severity of PAD and IMA levels were examined by logistic regression and receiver-operating characteristic (ROC) curve analyses.
IMA and adjusted-IMA levels were significantly higher in the PAD group (
< 0.001,
< 0.001, respectively). IMA and adjusted-IMA levels were significantly higher in PAD group 2, which had moderate-to-severe claudication and more pronounced ischemic symptoms (
< 0.001,
< 0.001, respectively). Advanced age, presence of hypertension, smoking, low albumin levels, and high adjusted-IMA levels were independent predictors of PAD. There was a negative high correlation between adjusted-IMA levels and ABI (
: -0.666,
< 0.001, Spearman's correlation). ROC curve analysis demonstrated that adjusted-IMA cut-off values of 0.802 or above could predict presence and severity of peripheral artery disease with 70% sensitivity and 78% specificity (AUC: 0.825, 95% CI: 0.758-0.893, log rank
: 0.000).
We determinated that increased adjusted-IMA levels were a predictors of the presence and severity of PAD. In addition, adjusted-IMA values can be a valuable marker in the follow-up of clinical severity of PAD.
Objective: Red cell distribution width (RDW) is a parameter of complete blood count (CBC). The RDW to platelet count ratio (RPR) is a new index that has been shown to reflect the severity of ...inflammation. We aim to determine the reference interval (RI) of RPR for premature newborns. Study design: The medical records of preterm infants who were followed up between January 2016 and December 2018 were reviewed. CBC levels were measured in 144 infants at <72 hours of age. Results: CBCs of infants (gestational age from 28 to 35weeks) had a RI of 0.038-0.126 for the RPR. The RI for RPR in infants with a gestational age of 32-35weeks was 0.042-0.129; and the RI for infants at 28-31weeks was 0.022-0.121. Conclusion: Establishment of RI for RPR in premature infants will allow clinical correlation of RPR alterations in this population.
In this study, we aimed to evaluate the initial hematological findings analyzed on admission in confirmed COVID-19 patients who were transferred to the intensive care unit (ICU), to predict possible ...hematological indices.
Initial neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), red cell distribution width to platelet ratio (RPR), mean platelet volume to platelet ratio, and lymphocyte multiplied by platelet count (LYM × PLT), of 695 patients with laboratory-confirmed COVID-19 were investigated and comparisons were made between the mild/moderate and severe groups.
The proportion of COVID-19 cases admitted to the ICU was 3.9%. The median age of patients admitted to the ICU was significantly higher than those who were not; 68.5 (interquartile range (IQR); 21.5 years vs. 41.0 (IQR; 15.7) years; P < 0.001.
Severe cases had higher NLR (6.6 vs. 2.4; P < 0.001), and MLR (0.40 vs. 0.28; P = 0.004) and lower PLR (180.0 vs. 129.0; P < 0.001) compared to that of mild or moderate patients. Among all of the parameters, the ROC curve of NLR gave us the best ability to distinguish serious patients at an early stage (AUC = 0. 819, 95% confidence interval 0.729–0.910; P < 0.001).
These data showed that age, initial NLR, PLR, and LYM × PLT were associated with the severity of COVID-19 disease and patients’ need for the ICU. Therefore, initial hemogram parameters may be essential to predict the prognosis of COVID-19 patients.
The quality of blood ethanol concentration (BEC) determination is important because of its legal ramifications. Measurement uncertainty provides quantitative information about the quality and ...reliability of test results. In this study, we aim to calculate the measurement uncertainty for the ethanol test in our laboratory measured with a Synchron Systems Ethanol assay kit by employing an enzymatic rate method on the Beckman-Coulter Olympus AU400 auto analyzer (Beckman Coulter Inc, Melville, USA).
The measurement uncertainty values were calculated in accordance to the Nordtest guidelines. All vehicle drivers involved in a traffic accident were retrospectively inspected for the BEC test conducted during July to December 2016 in our emergency laboratory.
A 1034 vehicle drivers had their BEC tested. The results for 181 drivers were > 0.50 g/L and reported as positive. The serum ethanol concentration in those showing a positive result was 2.04 ± 1.01 g/L, over four times the legal limit. The median BEC in those showing a negative result was 0.03 (IQR: 0.03) g/L. The expanded uncertainty obtained was 19.74%. When measurement uncertainty values were added to the results of the 1034 drivers who were retrospectively screened, eight vehicle drivers had results with 95% confidence intervals that exceeded the legal limit 0.50 g/L.
The BEC test results for vehicle drivers with values close to legal limits should be reported as the obtained ethanol concentration with corresponding measurement uncertainty.
Glycosaminoglycans (GAGs) are sulfated, negatively charged polysaccharides produced in almost every cell of the human body. As GAGs are extracellularly localized, the changes in body fluids such as ...blood and urine may reflect pathological changes in the urinary system as observed in other pathologies. In this review, we determined the potential of urinary and/or serum GAG levels as a marker for kidney and urothelial system diseases. We performed a search in the PubMed, MEDLINE, and ScienceDirect databases until September 30, 2019. A number of studies reported changes in the urinary and/or plasma GAG levels or composition in urological diseases and conditions, such as renal cell carcinoma, kidney stone, bladder carcinoma, and overactive bladder. GAGs were found to have a predictive biomarker potential that could be limited by generalizability concerns.
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